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[Jellyfish sting. An update].

Jellyfish are aquatic organisms, whose number increases under certain conditions of water temperature. They can sting humans, which can be fatal. The liberation of structures known as nematocysts induces the extrusion of the poison, to attack their victims. The poison produces characteristic local and systemic reactions. Since an increased number of these organisms has been detected in our coastline, we review the epidemiology, symptoms and diagnosis of the syndrome produced by the bite, to improve its management.

Animals↗

[Mastocytosis: an important differential diagnosis in anaphylactoid reaction to Hymenoptera sting. A case report and overview of clinical aspects, diagnosis and current therapy of mastocytosis].

A 77-year old farmer presented with a history of three severe anaphylactoid reactions after hymenoptera stings for the last three years. No sensitisation to hymenoptera venoms could be shown on allergological work-up. The serum level of tryptase however was clearly elevated (37.1 micrograms/l; normal value: < 13.5 micrograms/l). The diagnosis of systemic mastocytosis could be confirmed by bone marrow biopsy. Patients with mastocytosis are at increased risk of anaphylactic/anaphylactoid reactions. They should be educated how to avoid trigger factors and they should always carry an emergency kit (H1 blocker, corticosteroid, adrenalin) and a "mastocytosis pass" with them. Venom immunotherapy is indicated in patients with proven hymenoptera allergy. Selected patients at very high risk of anaphylactic reactions may need a continuous prophylactic medication with H1 and H2 blocker and eventually a cyclooxygenase inhibitor.

Aged↗

Box jellyfish (Carybdea alata) in Waikiki: their influx cycle plus the analgesic effect of hot and cold packs on their stings to swimmers at the beach: a randomized, placebo-controlled, clinical trial.

The study measured the analgesic effect of hot and cold packs on box jellyfish (Carybdea alata) stings to Waikiki swimmers at the beach. Analysis of data showed a minimal trend toward pain relief 10 minutes after the application of hot packs, particularly when the initial pain was mild to moderate. Cold packs showed no clinically significant relief of pain, compared to the control. Data tracking shows that most box jellyfish appear in Waikiki waters on the 9th or 10th day after the full moon.

Analgesia↗

[Acute myocardial infarction after wasp sting].

Myocardial infarction after wasp sting is a rare event and this complication has been described in only a few previous occasions. We report the case of a 77-year-old patient admitted to our hospital because of an anaphylactic shock after he was stung by a wasp on the fifth finger of the left hand. Within about half an hour he sustained an acute myocardial infarction. Possible pathogenetic mechanisms include severe hypotension due to hypovolemic shock and coronary spasm with subsequent thrombosis of coronary vessels developed after the release of vasoactive, inflammatory and thrombogenic substances contained in the hymenoptera venom.

Aged↗

Ant sting sporotrichosis.

Cutaneous sporotrichosis is an uncommon infection, usually reported as sporadic cases resulting from inoculation with sharp environmental vegetative matter. We report such a case of multiple primary inoculations acquired from Solenopsis (fire ant) stings in a 54-year-old white man. The patient was treated effectively with itraconazole 200 mg twice a day for 4 months.

Animals↗

Aquatic antagonists: Catalaphyllia jardinei sting.

Catalaphyllia jardinei is a blue-green soft coral whose red-violet tipped tentacles have made it a very colorful, popular animal prized by amateur aquarists (Figure 1). Its normal habitat is the Indo-Pacific area from Seychelles through Vanuatu and from Northern Australia to Southern Japan. It is regarded as mildly venomous. However, to our knowledge, no reports exist on its sting's effects on man.

Anthozoa↗

[Mortality from snake bites, wild and domestic animal bites and arthropod stings in the savannah zone of eastern Senegal].

From 1976 to 1999, we conducted a prospective study of overall and cause-specific mortality among the population of 42 villages of south-eastern Senegal. Of 4,228 deaths registered during this period, 26 were brought on by snakebites, 4 by invertebrate stings and 8 by other wild or domestic animals. The average annual mortality rate from snakebite was 14 deaths per 100,000 population. Among persons aged 1 year or more, 0.9% (26/2,880) of deaths were caused by snakebite and this cause represented 28% (26/94) of the total number of deaths by accident. We also investigated the snake fauna of the area. Of 1,280 snakes belonging to 34 species that were collected, one-third were dangerous and the proportion of Viperidae, Elapidae and Atractaspididae was 23%, 11% and 0.6%, respectively. The saw-scaled viper Echis ocellatus was the most abundant species (13.6%). Other venomous species were Causus maculatus (6.5%), Naja katiensis (5.5%), Bitis arietans (2.7%), Elapsoidea trapei (2.4%), Naja nigricollis (1.2%), Naja melanoleuca (1.1%), Atractaspis aterrima (0.4%), Dendroaspis polylepis (0.3%) and Naja haje (0.1%).

Adolescent↗

[Scorpion stings in sub-Saharan Africa].

Scorpionism in Sub-Saharan Africa is a poorly known problem but regarded as a public health preoccupation in several countries, especially Niger. The lack of knowledge of this question is due to non-existent information concerning mainly the composition of the scorpion fauna in Sub-Saharan areas, the distribution and density of dangerous species and the frequency and severity of scorpion stings in the Sub-Saharan areas. Until now, only the presence of Leiurus quinquestriatus and its involvement in fatal accidents have been attested to. In many areas, the presence of other classically dangerous species has not been confirmed, nor the dangerous potential of certain species belonging for example to the genera Androctonus. Buthus or Hottentota. The efficacy of prevention, treatment and scorpion control depend necessarily on further study of the fauna and medical investigations. Such studies are entirely feasible.

Africa South of the Sahara↗

Radial artery injury from a catfish sting.

We present a case of an isolated radial artery laceration injury secondary to a catfish sting. Six months after surgical removal of the cartilaginous spine and primary repair of the vessel wall, the patient had an uneventful follow-up with minimal symptoms of cold intolerance and maintained arterial patency as documented by Allen's test and ultrasound.

Adult↗

Prevalence of allergic reactions to Hymenoptera stings in northern Italy.

The epidemiology of Hymenoptera venom allergy in Europe showed prevalence of systemic reactions of about 3%, but is scantly investigated in Italy. We studied two samples of the general and an at risk population, i.e. the foresters, in northern Italy. A standardized questionnaire dealing with allergic reactions to Hymenoptera stings was submitted to the subjects included in the study, who were factory workers in Milan and Verona and foresters in Lombardy. An overall number of 574 subjects participated to the study, 462 (299 males and 163 females, mean age 40.1 yrs, range 20-63 yrs) were factory workers and 112 (all males, mean age 38.8 yrs, range 24-59 yrs) were foresters. Among factory workers, 302 (65.4%) were stung by Hymenoptera, 49 (10.6%) had had large local reactions, and 13 (2.8%) systemic reactions. Among foresters, 76 (67.8%) were stung, 11 (9.8%) had had large local reactions, and 5 (4.5%) systemic reactions. The systemic reactions were life-threatening in 3 (0.6%) industrial workers and 2 (1.8%) foresters. The prevalence of systemic reaction of 2.8% in the general population agrees with the data reported from a number of countries with temperate climate. The prevalence of 4.5% in foresters attributed to this population a risk only slightly increased.

Adult↗

Unusual case of anuria due to African bee stings.

We describe a case of multiple African bee stings in which the exceptionally high dose suggests a direct effect of hymenoptera venom on the renal tubules. The case does not follow the previously reported pattern of hypovolemic or anaphylactic shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of venom injected.

Animals↗

Myasthenia gravis and acute respiratory muscle paralysis following wasp sting.

A 34-year-old lady presented with generalised weakness of body, indistinguishable from myasthenia gravis within 24 hours of a wasp sting. Respiratory muscle paralysis leading to respiratory failure developed and mechanical ventilatory support was required. The patient made an uneventful recovery.

Acute Disease↗

[Insect stings and their sequelae].

In the summer months, insect stings are a common reason for seeking help from the general physician. In the majority of cases a local reaction is seen, but, far less often, an anaphylactic reaction may also occur. Such an acute situation requires calm but decisive action, and the initiation of an evaluation by an allergy specialist. The family doctor should regularly review the facilities for treating an anaphylactic reaction in his office, and, where necessary, optimize them.

Anaphylaxis↗

Hand wound caused by an active sting with a toxin spine of a catfish (Heteropneustes fossilis)--a case report.

A case of a 33-years-old aquarist admitted to the Clinic with a painful wound caused by a Stinging Catfish (Heteropneustes fossilis) was presented. While cleaning the aquarium the fish actively stung him in the hand. After irrigating and debriding of the wound the patient was given tetanus anatoxin and antibiotic course. The opioid analgesia and local anesthesia had to be provided to relieve the pain. The follow up after 2 weeks showed healed wound of the hand and the patient had no subjective complaints. There is an urgent need for a bill about venomous and poisonous animals which will be allowed to be kept at home. The registration of venomous and poisonous animals in the Regional Poison Control Centers should be compulsory. There is a need for initiating educational activity among people who keep dangerous animals at home as their pets.

Adult↗