Venomous fish stings in tropical northern Australia

Venomous fish stings are a common environment hazard worldwide. This study investigated the clinical effects and treatment of venomous fish stings. A prospective observational case series of patients presenting with venomous fish stings was conducted in tropical northern Australia. Twenty-two fish stings were included; subjects were 3 females and 19 males; mean age 35 (range 10-63). 9 by stingrays, 8 by catfish, 1 by a stonefish, 1 by a silver scat (Selenotocota multifasciata), and 3 by unknown fish. All patients had severe pain, but less commonly erythema, 3 cases (14%); swelling, 7 cases (33%); bleeding, 5 cases (24%); numbness, 4 cases (19%); and radiating pain, 3 cases (14%). Mild systemic effects occurred in one stingray injury. Treatment included hot water immersion, which was completely effective in 73% of cases, analgesia, wound exploration and prophylactic antibiotics. Stingray injuries should be explored and debrided with large wounds, while other stings only need appropriate cleaning. The routine use of antibiotics is not recommended. (Am J Emerg Med 2001;19:561-565. Copyright © 2001 by W.B. Saunders Company)