Jellyfish Stings

Jellyfish nematocysts inject a mixture of proteinaceous toxins through hollow, barbed tubes into their victims' skin at an approximate force of 2 to 5 pounds per square inch. The venom enters the dermis and general circulation and can cause both skin and systemic symptoms in affected patients.

In tropical northern Australia, stings from the major box jellyfish Chironex fleckeri continue to result in about one pediatric death in a remote area every two to three years. There are more nonfatal and less severe cases mainly in the Northern Territory [5]. A few hundred cases of Irukandji syndrome from other box jellyfish, including Carukia barnesi, occur in the same region each year [6,7]. Physalia stings are very common throughout the country.

How many type of Jelly Fish and how will you manage jelly fish sting ?

Box jelly fish

Blue Bottle Jelly fish

Irukandji syndrome…. Jelly fish (Northen Queensland Area)

Irukandji syndrome typically involves a mild to moderately painful local sting that is followed 20 to 40 minutes later by the onset of severe generalized back, chest, and abdominal pain, gastrointestinal symptoms, sweating, agitation, hypertension, and tachycardia. Patients may develop myocardial injury and pulmonary edema 6 to 18 hours after the sting.

Carukia barnesi, found in Northern Australian waters, was the first jellyfish identified to cause Irukandji syndrome. C. barnesi is a creature with a tiny bell (often 2 cm in diameter) and long tentacles. Other Australian jellyfish may also cause some cases of Irukandji syndrome.

S/S

"Tentacle prints" may be seen on examination of the skin, and less commonly vesiculation and ecchymosis

Major box jellyfish (Chironex fleckeri) stings have caused more than 70 known deaths in Australia [16]. Multiple tentacles arise from the four corners of this large jellyfish and may stretch up to 2 m. These tentacles are lined with nematocysts containing venom that has produced cardiotoxic and dermonecrotic effects in the clinical setting, and experimental in vitro hemolytic effects. While most Australian box jellyfish stings are of little consequence, with large tentacular contact patients can experience rapid onset of cardiac arrest within minutes of the sting. Delayed hypersensitivity reactions occurring 7 to 14 days after the sting, consisting of papular urticaria at the initial site of contact are common.

Seabather's eruption — Seabather's eruption is an itchy dermatitis that has been described in Florida, the Caribbean, Bermuda, and Long Island, New York

Treatment of seabather’s eruption is symptomatic and typically consists of oral antihistamines (eg, diphenhydramine, hydroxyzine, or loratadine), topical antipruritic agents (eg, calamine lotion), and low (genital) or medium potency (trunk or limbs) topical corticosteroid preparations. Oral steroid in more severe cases.

Dx -

Mostly clinical

Skiin scrapping and microscopy for definitive diagnosis and to differentiate the type of nematocysts of various jellyfish

Tx -

1st line - nematocyst removal