Abstract
Freshwater stingrays cause many serious human injuries, but identification of the offending species is uncommon. The present case involved a large freshwater stingray, Potamotrygon motoro (Chondrichthyes: Potamotrygonidae), in the Araguaia River in Tocantins, Brazil. Appropriate first aid was administered within ~15 min, except that an ice pack was applied. Analgesics provided no pain relief, although hot compresses did. Ciprofloxacin therapy commenced after ~18 h and continued seven days. Then antibiotic was suspended; however, after two more days and additional tests, cephalosporin therapy was initiated, and proved successful. Pain worsened despite increasingly powerful analgesics, until debridement of the wound was performed after one month. The wound finally closed ~70 days after the accident, but the patient continued to have problems wearing shoes even eight months later. Chemistry and pharmacology of Potamotrygon venom and mucus, and clinical management of freshwater stingray envenomations are reviewed in light of the present case. Bacterial infections of stingray puncture wounds may account for more long-term morbidity than stingray venom. Simultaneous prophylactic use of multiple antibiotics is recommended for all but the most superficial stingray wounds. Distinguishing relative contributions of venom, mucus, and bacteria will require careful genomic and transcriptomic investigations of stingray tissues and contaminating bacteria.
Highlights
Freshwater stingrays are elasmobranchs belonging to the monophyletic Family Potamotrygonidae, Garman, 1877
Domingos et al [34] reported that antibiotic resistance of bacteria associated with stingray mucus is common, especially to ampicillin, amoxycillin/clavulanic acid, and cephalotin; 23% of their bacterial isolates were resistant to all but one of the sixteen antibiotics they tested
We report a severe human accident involving an ocellate river stingray in central Brazil and we discuss implications for public health strategies related to freshwater stingray envenomations
Summary
Freshwater stingrays are elasmobranchs belonging to the monophyletic Family Potamotrygonidae, Garman, 1877. Even though the mucus contains elements of the non-specific immune system, it harbors bacteria of many types The stingers, with their associated secretory cells and mucus, constitute the only physical defensive weapon of these fishes [6,21,22,23,24,25,26,27,28]. We report a severe human accident involving an ocellate river stingray in central Brazil and we discuss implications for public health strategies related to freshwater stingray envenomations. What makes this case unusual is that the victim, one of the co-authors of this report, was raised in the region where the accident occurred. The resulting case report is the most detailed of which we are aware
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