We retrospectively reviewed stingray stings presenting to our Emergency Department (ED) over an 8-year period. Cases were divided into acute (group 1, within 24 h of the sting) and subacute (group 2, 24 h or more after the sting) presentations. [ncbi.nlm.nih.gov]

Stingray envenomation: a retrospective review of clinical presentation and treatment in 119 cases. J Emerg Med. 2007;33:33–37. [ PubMed ] [westjem.com]

• Axillary Pain

  Lymphangitis, vomiting, diarrhea, sweating, generalized cramps, inguinal or axillary pain, respiratory distress, and death have been reported. [msdmanuals.com]

  The pain may radiate centrally, peaks at 30 to 60 minutes, and may last for up to 48 hours. [aneskey.com]

• Soft Tissue Swelling

  (Fig. 3) There was increased soft tissue swelling with slight tissue crepitus. His laboratory data revealed a 16,000 white count with a left shift. [faoj.org]

  X-Ray of the wrist revealed no retained foreign body or bone erosions but there was some soft tissue swelling. Specimens were taken from the wound for culture. [toxinology.com]

• Hyperthermia

  Sympathetic (adrenergic) effects are manifested as tachycardia, hypertension, mydriasis, hyperthermia, hyperglycaemia, and agitation. Fatal effects of scorpion envenomation are largely due to cardiovascular effects. [hkmj.org]

  During this state or period there are “malaise (not constant), anxiety and restlessness (not constant), hyperthermia discrete (non-constant), pain, red moderate and localized edema, eschar formation constant and segregating perilesional and ulcer torpid [jvat.biomedcentral.com]

• Congestive Heart Failure

  heart failure, and syncope. [potamotrygon.de]

• Rales

  There was rales on the basal part of the right pulmonary. On laboratory result were found an increase of leucocytes, mild hypokalemia, evidence of acute kidney injuries (Table 1) and ECG reveal sinus tachycardia. [medcraveonline.com]

• Nausea

  Systemic side effects can be seen, including nausea, vomiting, salivation, dyspnea, cardiac dysrhythmias, syncope, hypotension, seizures, fasciculations, and, rarely, death. [nursingcenter.com]

  Syncope, weakness, nausea, and anxiety are common and may be due, in part, to peripheral vasodilation. Lymphangitis, vomiting, diarrhea, sweating, generalized cramps, inguinal or axillary pain, respiratory distress, and death have been reported. [msdmanuals.com]

• Vomiting

  Systemic side effects can be seen, including nausea, vomiting, salivation, dyspnea, cardiac dysrhythmias, syncope, hypotension, seizures, fasciculations, and, rarely, death. [nursingcenter.com]

  The pain from a stingray wound can be excruciating and accompanied by bleeding, weakness, vomiting, headache, fainting, shortness of breath, paralysis, collapse and occasionally, death. [diversalertnetwork.org]

• Abdominal Pain

  It causes severe pain, vasoconstriction, ischemia, and poor wound healing, along with systemic effects such as disorientation, syncope, seizures, salivation, nausea, vomiting, abdominal pain, diarrhea, muscle cramps or fasciculations, pruritus, allergic [mdedge.com]

  fasciculations, abdominal pain, seizures and hypotension. 5 Stingray venom is a very heat sensitive protein. [podiatrytoday.com]

  If you’re stung by a stingray, you may experience these symptoms: abdominal pain anxiety bleeding diarrhea dizziness extreme pain at the wound site fatigue headache low blood pressure muscle cramps nausea necrosis (death) of surrounding tissue pain in [healthline.com]

  […] with Ciguatera Poisoning Gastrointestinal* Nausea or vomiting Profuse, watery diarrhea Abdominal pain Neurologic † Numbness Paresthesias Vertigo Ataxia Severe weakness or lethargy Severe myalgia Decreased vibration and pain sensations Diffuse pain Cold [aafp.org]

• Abdominal Cramps

  The symptoms—which include any or all of the following: flushing, nausea, vomiting, diarrhea, severe headache, palpitations, abdominal cramping, dizziness, dry mouth, urticaria, and conjunctival injection—typically last less than six to eight hours. 4 [aafp.org]

• Epigastric Pain

  After contacted with stingray, he started experience excruciating pain (VAS Score 9), calf cramp, nausea, and epigastric pain. [medcraveonline.com]

• Hypotension

  Systemic side effects can be seen, including nausea, vomiting, salivation, dyspnea, cardiac dysrhythmias, syncope, hypotension, seizures, fasciculations, and, rarely, death. [nursingcenter.com]

  Severe hypotension may require the use of pressors. [aafp.org]

• Heart Failure

  Cardiotoxins affect the heart, enough cardiotoxin causes cadiac failure. As with neurotoxins, cardiotoxins take a while to take effect. [panoptesv.com]

  Our patient came to ER after 6 hours of contact with systemic envenomation include seizures, excruciating pain, shortness of breathing, excruciating pain, epigastric pain and symptoms of heart failures. [medcraveonline.com]

  Symptoms include: blood loss, chills, cramps, delirium, diarrhea, difficulty or stopping of breathing, dizziness, fainting, fever, heart failure, hives, low blood pressure, nausea, paralysis, seizures and swelling. All creatures are not friendly. [littleraychildrensbooks.com]

• Increased Sweating

  Antivenom indications include increasingly severe pain, proximal spread of muscle spasm/rigidity, increased sweating and hypertension. Antivenom is not used routinely for spider envenomations in the United States because of concern for anaphylaxis. [saem.org]

• Cutaneous Manifestation

  Also see Cutaneous Manifestations Following Exposures to Marine Life. Prognosis Stingray injuries (eg, puncture wounds, lacerations, envenomations) tend to have good outcomes. [emedicine.medscape.com]

• Photosensitive Skin Rash

  As with doxycycline, many individuals can develop photosensitive skin rashes while on the medication. [emedicine.medscape.com]

• Myalgia

  ‡ Bradycardia Hypotension TABLE 2 Symptom Patterns Associated with Ciguatera Poisoning Gastrointestinal* Nausea or vomiting Profuse, watery diarrhea Abdominal pain Neurologic † Numbness Paresthesias Vertigo Ataxia Severe weakness or lethargy Severe myalgia [aafp.org]

  Only a few patients develop systemic symptoms such as nausea, vomiting, abdominal pain, myalgia and rarely respiratory distress. 3 Treatment of bluebottle stings The bluebottle should be washed off with seawater or carefully removed and then the sting [nps.org.au]

• Painful Muscle Cramps

  Common presentations include local pain, muscle cramps, vomiting, and diarrhea, and rare complications include artery laceration and compartment syndrome. [westjem.com]

  muscle cramps, fasciculations, generalized edema (with truncal wounds), paralysis, hypotension, arrhythmias, and death. 47, 58 The paralysis may represent spastic muscle contractures induced by pain, which are a tremendous hazard for a diver or swimmer [aneskey.com]

• Seizure

  He brought to local primary health center 5 hours later and taken oral NSAID (mefenamic acid) and amoxicillin was given, 15 minutes later patient started having seizures. [medcraveonline.com]

  Systemic side effects can be seen, including nausea, vomiting, salivation, dyspnea, cardiac dysrhythmias, syncope, hypotension, seizures, fasciculations, and, rarely, death. [nursingcenter.com]

• Dizziness

  Study co-author Bryan Fry surmises that this combination “can produce sensations of extremely unpleasant nausea and dizziness.” While the predator is reeling, the fang blenny flees. [theverge.com]

  Call 911 if the person has symptoms of a severe allergic reaction, such as: Difficulty breathing Tightness in throat Itching Nausea Fast pulse Dizziness Loss of consciousness See Severe Allergic Reaction Treatment. 1. [webmd.com]

  Symptoms of Stingray Stings extreme pain (can last as long as two days) bleeding swelling around the wound redness or blue coloring around the wound dizziness muscle cramps or weakness seizures irregular pulse low blood pressure Because most stings come [verywellhealth.com]

  The pain is felt sharply and immediately and is accompanied by major swelling, local paralysis and dizziness. In addition, the victim’s vision, speech and awareness may be impaired. [baignades.sante.gouv.fr]

  If you’re stung by a stingray, you may experience these symptoms: abdominal pain anxiety bleeding diarrhea dizziness extreme pain at the wound site fatigue headache low blood pressure muscle cramps nausea necrosis (death) of surrounding tissue pain in [healthline.com]

• Vertigo

  Systemic manifestations may include weakness, nausea, vomiting, diarrhea, sweating, vertigo, tachycardia, headache, syncope, muscle cramps, paralysis, hypotension, arrhythmias, and even death. [drralph.net]

  […] benefit. 3 [Evidence level A, randomized controlled trial (RCT)] View/Print Table TABLE 2 Symptom Patterns Associated with Ciguatera Poisoning Gastrointestinal* Nausea or vomiting Profuse, watery diarrhea Abdominal pain Neurologic † Numbness Paresthesias Vertigo [aafp.org]

  […] tissue wound have been noted. 83 All of this is indicative of an immunologic reaction, which, if present, might contribute to the delayed healing of stingray injuries. 44 Systemic manifestations include weakness, nausea, vomiting, diarrhea, diaphoresis, vertigo [aneskey.com]

  Systemic symptoms include nausea, vomiting, diarrhea, diaphoresis, vertigo, tachycardia, headache, syncope, seizures, muscle cramps, fasciculations, generalized edema, paralysis, hypotension, arrhythmias, and death. Treatment. [ahcmedia.com]

• Staphylococcus Aureus

  Tissue cultures revealed Staphylococcus aureus. He was placed on IV Levaquin. His initial infection took about a week to resolve and he was discharged from the hospital. [faoj.org]

  It is indicated for Staphylococcus aureus and infections caused by multidrug resistant gram-negative organisms. [emedicine.medscape.com]

  Serious complication more likely caused by untreated infection, most infection resulted by the microorganism that found in water of injuries site, common pathogens to infect the wound include staphylococcus aureus and streptococcus species. [medcraveonline.com]

If treatment is delayed, infection from marine bacteria often requires hospitalization including intravenous antibiotics and surgical treatment. [faoj.org]

We present an accumulation of 21 cases of stingray injuries with accurate temperature levels for optimum treatment of pain. [jucm.com]

Treatment of stingray injury with topical becaplermin gel. J Am Podiatr Med Assoc 1999; 89: 531-3. Rocca A, Moran E, Lippert F. III. Hyperbaric oxygen therapy in the treatment of soft tissue necrosis resulting from a stingray puncture. [new.medigraphic.com]

The recommended initial treatment is immersion in hot water that patients maintain at a temperature of 110º to 115º (if tolerable) for 30 to 90 minutes. [podiatrytoday.com]

Prognosis Stingray injuries (eg, puncture wounds, lacerations, envenomations) tend to have good outcomes. If patients do not develop infection or other complications, they can expect to have minimal pain in 24-48 hours and healing within 1-2 weeks. [emedicine.medscape.com]

[…] into the throat, and breathing machine ECG (electrocardiogram, or heart tracing) Intravenous fluids (through a vein) Medicine called an antiserum to reverse the effect of the venom Medicine to treat symptoms Tetanus shot, if necessary X-rays Outlook (Prognosis [mountsinai.org]

Some of these effects can be explained by allergy and psychological reactions, and stingray experts are unsure as to the true extent to which systemic effects, or their absence, are consistent and dependable signs of a realistic prognosis. [potamotrygon.de]

Cytosolic phospholipase A2-alpha expression in breast cancer is associated with EGFR expression and correlates with an adverse prognosis in luminal tumours. [worldwidescience.org]

Lacking history of a bite, other causes of skin ulceration should be considered, including infectious, inflammatory, vascular, and neoplastic etiologies. [saem.org]

The etiology is thought to be Mycoplasma species, possibly phocidae or phocacerebrale. 1 Recommended therapy is oral tetracycline 1.5 g initially, followed by 500 mg four times daily for 4-6 weeks. [ahcmedia.com]

Directory of Open Access Journals (Sweden) Benoit Raymond 2007-12-01 Full Text Available Bacillus anthracis, the etiological agent of anthrax, is a spore-forming gram-positive bacterium. [worldwidescience.org]

Freshwater stingrays: Study of epidemiologic, clinic and therapeutic aspects based on 84 envenomings in humans and some enzymatic activities of the venom. Toxicon 2004; 43: 287-94. Machado-Allison A, Rodríguez-Acosta A. [new.medigraphic.com]

OBJECTIVE: A descriptive and prospective survey was conducted to analyze epidemiological, clinical and treatment aspects of injuries caused by marine stingrays in Adicora, Paraguaná peninsula, Falcon State, a northwestern, semiarid region of Venezuela [read.qxmd.com]

Electronic address: This article describes the epidemiology and presentation of human envenomation from marine organisms. [pubfacts.com]

Clinical and epidemiological aspects of scorpionism in the world: a systematic review. Wilderness Environ Med 2016;27:504-18. Crossref 28. Chippaux JP, Goyffon M. Epidemiology of scorpionism: a global appraisal. Acta Trop 2008;107:71-9. Crossref 29. [hkmj.org]

Freshwater stingrays: study of epidemiologic, clinical and therapeutic aspects based on 84 envenomings in humans and some enzymatic activities of the venom. Toxicon 2004 ; 43 : 287 – 294. 11. [academic.oup.com]

Aquatic emergencies: pathophysiology and treatment for underwater stings. J Emerg Med Serv 2004 ; 29 : 102 – 103. © 2008 International Society of Travel Medicine [academic.oup.com]

Venom pathophysiology, envenomation presentation, and treatment options are discussed for sea snake, stingray, spiny fish, jellyfish, octopus, cone snail, sea urchin, and sponge envenomation. [pubfacts.com]

Therefore, understanding mechanisms of neutrophil recruitment is of major physiological and pathophysiological importance. [nature.com]

As with many types of dive accidents, prevention is the best medicine when it comes to stingray accidents. [justgottadive.com]

Get the skills you need now with new information on global humanitarian relief and expedition medicine, plus expanded coverage of injury prevention and environmental preservation. [books.google.com]

Prevention : Stingrays are known to be skittish, avoidant creatures. When they happen to injure humans, it is out of self-defense. Thus, simple patient education during a visit after a stingray injury can help prevent future similar encounters. [aaemrsa.blogspot.com]