Hot water immersion as a treatment for stonefish sting: A case report

  • Darlene F. Ongkili
  • Phee-Kheng Cheah
Keywords: scorpaenidae, synanceiidae, stonefish, envenomation, hot water immersion

Abstract

The North Borneo state of Sabah is known worldwide for its beautiful islands and dive sites. Local hospitals deal with a number of marine-related injuries, including marine fauna envenomation by Scorpaenidae and Synanceiidae families of fish. We report a case of a tourist who presented with excruciating pain on her right foot after stepping on a stonefish. Despite being given parenteral analgesia and regional anaesthesia, the pain persisted. Her pain improved after she soaked her foot in hot water for about 30 minutes. No further treatment was required. We reviewed the literature comparing this inexpensive mode of treatment with other conventional treatments. We also explored the possibility of using hot water immersion for treatment of envenomation by other types of marine animals.

References

1. Fernandez I, Valladolid G, Varon J, Sternbach G. Encounters with venomous sea-life. J Emerg Med 2011;40(1):103-12.

Auerbach PS. Marine envenomations. N Engl J Med 1991;325:486-93.

Gallagher SA. Lionfish and stonefish. In: Emergency Medicine. Available at: http://www.emedicine.com/emerg/topic300.htm. Accessed 2011.

Singletary EM, Rochman AS, Bodmer JCA, Holstege CP. Envenomations. Med Clin N Am 2005;89:1195-224.

Khoo HE. Bioactive proteins from stonefish venom. Clin Experimental Pharmacol Physiol 2002;29:802-806.

Ngo SYA, Ong SHJ, Ponampalam R. Stonefish envenomation presenting to a Singapore hospital. Singapore Med J 2009;50(5):506-9.

Atkinson PRT, Boyle A, Hartin D, McAuley. Is hot water immersion an effective treatment for marine envenomation? Emerg Med J 2006;23:503-8.

Russell FE. Weever fish sting: the last word. Br Med J 1983;287:981-2.

Lau KK, Chan CK, Tse ML, Lau FL. Hot water immersion therapy with a thermal isolator in patient with marine envenomation. Hong Kong J Emerg Med 2011;18:204-9.

Kizer KW, McKinney HE, Auerbach PS. Scorpaenidaeenvenomation: a five-year poison center experience. JAMA 1985;253(6):807 [abstract].

Ling SKK, Cheng SC, Yen CH. Stonefish envenomation with acute carpal tunnel syndrome. Hong Kong Med J 2008;15(6):471-3.

Yamamoto R, Suzuki M, Hori S, Aikawa N. Stonefish “Okoze” envenomation during food preparation. Keio J Med 2010;59(1):19-22.

Lee JYL, Teoh LC, Leo SPM. Stonefish envenomation of the hand – a local marine hazard: a series of 8 cases and review of the literature. Ann Acad Med Singapore 2004;33(4):515-20.

Stonefish antivenom product information sheet. Australia, CSL Limited. Available at: http://www.csl.com.au. Accessed November 2011.

Gomes HL, Menezes TN, Carnielli JBT, Andrich F et al. Stonefish antivenom neutralizes the inflammatory and cardiovascular effects induced by scorpionfish Scorpaena plumieri venom. Toxicon 2011;57:992-9.

Muirhead D. Applying pain theory in fish spine envenomation. South Pac Underwater Med Soc J. 2002;32(3):150-3.

Tang WM, Fung KK, Cheng VC, Lucke L. Rapidly progressive necrotising fasciitis following a stonefish sting: a report of two cases. J Ortho Surg 2006;14(1):67-70.

Loten C, Stokes B, Worsley D, Seymour J, Jiang S, Isbister GK. A randomised controlled trial of hot water (45°C) immersion versus ice packs for pain relief in bluebottle stings. Med J Aust 2006;184:329-33.

Carrette TJ, Cullen P, Little M, Peiera PL, Seymour JE. Temperature effects on box jellyfish venom: a possible treatment for envenomed patients? Med J Aust 2002;177:654-5.

Published
2012-03-31
How to Cite
F. Ongkili, D., & Cheah, P.-K. (2012). Hot water immersion as a treatment for stonefish sting: A case report. Malaysian Family Physician, 8(1), 5. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/111
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Articles