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General Sports Medicine

Marine Envenomations

: Recognizing and Managing Sea Creature Stings Marine envenomations are an uncommon but important consideration in water sports including swimming, diving, scuba, fishing, surfing, wakeboarding and others.

A
Andrew Schleihauf
Sports Medicine Physician ยท February 16, 2020 ยท 3 min read

Overview

: Recognizing and Managing Sea Creature Stings Marine envenomations are an uncommon but important consideration in water sports including swimming, diving, scuba, fishing, surfing, wakeboarding and others. They occur predominantly in tropical waters. Most envenomations occur not as an attack but act of self defense when an animal perceives danger.

Symptoms

There are over 100,000 species, 100 of which are known to be poisonous. In general, marine envenomations are not well studied and thus many guidelines are based on case reports or case series. In the united states, envenomations are most commonly seen in Jellyfish (31%), followed by stingrays (16%) venomous fish venomous fish (including lionfish, catfish, and others) (28%), and gastropods (6%).

Causes and Risk Factors

In the US, there are 1500 stingray bites annually and globally there are thousands of injuries with few fatalities [2, 3]. In general, marine venoms generally contain heat labile proteins which quickly denature with hot water. Although they will not be reviewed in detail remember to consider tetanus booster and antibiotics covering staph, strep and vibrio.

Treatment Options

We also will not spend too much time discussing analgesic options, of which there are many. If you have questions, always call the poison control center 222-1222. Nematocysts (Phylum: Cnidaria) Example of seabather's eruption (courtesy of the Dr Andrew Schmidt) Seabather's eruption.

Recovery

This a non-specific dermatitis secondary to nematocyst exposure. Symptoms include pruritic papules resembling insect bites in the distribution of swimsuit which often occurs during a shower after swimming in ocean as fresh water ruptures larvae. Treatment includes bathing the skin with acetic acid 5%, or lidocaine-containing first aid remedy.

When to See a Doctor

If you are experiencing symptoms that may be related to marine envenomations, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

General Sports Medicine
A
Andrew Schleihauf
Sports Medicine Physician
Sports Medicine Review contributor

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