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Stonefish envenomation of hand with impending compartment syndrome.

Tay TK, Chan HZ, Ahmad TS, Teh KK, Low TH, Wahab NA - J Occup Med Toxicol (2016)

Bottom Line: Possible contact to various marine life occurs during diving, fishing and food handling.Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment.Stonefish is one of the most venomous fish in the world with potential fatal local and systemic toxicity effects to human.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

ABSTRACT

Background: Marine stings and envenomation are fairly common in Malaysia. Possible contact to various marine life occurs during diving, fishing and food handling. Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment. Stonefish is one of the most venomous fish in the world with potential fatal local and systemic toxicity effects to human.

Case presentation: We reported a case of stonefish sting complicated with impending compartment syndrome.

Conclusions: Medical staff should be alert about the possibility of this potential emergency in standard management of stonefish stings.

No MeSH data available.


Related in: MedlinePlus

Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm
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Fig1: Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm

Mentions: Twelve hours later, the pain had progressively worsened again and swelling had spread to involve the dorsum and radial half of his right hand (Fig. 1). Blisters appeared on his right index finger and he had paraesthesia over the median nerve distribution over the affected hand. Sensation reduced over the tip of right index finger and oxygen saturation on pulse oximeter dropped to 89 %, which raised the fear of impending compartment syndrome associated with symptoms of acute carpal tunnel syndrome. Clinically, patient was afebrile with stable vital signs. Laboratory results, including a white blood cell count, haemoglobin level, clotting profile; renal (electrolytes) and liver function tests were all normal. No gas shadow was seen in the right hand plain radiograph. All Gram stains and subsequent cultures were negative. There was no specific anti-venom for stonefish available in National Poison Centre. Patient was treated with warm water immersion and elevation in between immersion. Swelling gradually subsided. Fasciotomy was not required as the patient had responded well with the conservative management. His right hand swelling and circulation improved gradually. There was no local skin necrosis. Patient was discharged well with good recovery from pain and numbness after 4 days of hospital stay. There was no associated neurogenic or vascular sequelae noted during subsequent follow up. He had a full motion in his fingers and wrists joints at six weeks follow up.Fig. 1


Stonefish envenomation of hand with impending compartment syndrome.

Tay TK, Chan HZ, Ahmad TS, Teh KK, Low TH, Wahab NA - J Occup Med Toxicol (2016)

Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4862076&req=5

Fig1: Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm
Mentions: Twelve hours later, the pain had progressively worsened again and swelling had spread to involve the dorsum and radial half of his right hand (Fig. 1). Blisters appeared on his right index finger and he had paraesthesia over the median nerve distribution over the affected hand. Sensation reduced over the tip of right index finger and oxygen saturation on pulse oximeter dropped to 89 %, which raised the fear of impending compartment syndrome associated with symptoms of acute carpal tunnel syndrome. Clinically, patient was afebrile with stable vital signs. Laboratory results, including a white blood cell count, haemoglobin level, clotting profile; renal (electrolytes) and liver function tests were all normal. No gas shadow was seen in the right hand plain radiograph. All Gram stains and subsequent cultures were negative. There was no specific anti-venom for stonefish available in National Poison Centre. Patient was treated with warm water immersion and elevation in between immersion. Swelling gradually subsided. Fasciotomy was not required as the patient had responded well with the conservative management. His right hand swelling and circulation improved gradually. There was no local skin necrosis. Patient was discharged well with good recovery from pain and numbness after 4 days of hospital stay. There was no associated neurogenic or vascular sequelae noted during subsequent follow up. He had a full motion in his fingers and wrists joints at six weeks follow up.Fig. 1

Bottom Line: Possible contact to various marine life occurs during diving, fishing and food handling.Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment.Stonefish is one of the most venomous fish in the world with potential fatal local and systemic toxicity effects to human.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

ABSTRACT

Background: Marine stings and envenomation are fairly common in Malaysia. Possible contact to various marine life occurs during diving, fishing and food handling. Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment. Stonefish is one of the most venomous fish in the world with potential fatal local and systemic toxicity effects to human.

Case presentation: We reported a case of stonefish sting complicated with impending compartment syndrome.

Conclusions: Medical staff should be alert about the possibility of this potential emergency in standard management of stonefish stings.

No MeSH data available.


Related in: MedlinePlus