How to Manage Lionfish Envenomation?

Abstract

Lionfish have highly toxic venom and envenomation may result in a wide spectrum of complaints in humans ranging from sharp pain to infection and necrosis of the soft tissue. Symptoms of lionfish envenomation include sharp pain, swelling, redness, bleeding, nausea, numbness, anxiety, joint pain, headache, dizziness, and even anaphylactic reaction resulting in death. Treatment involves applying immersion of the affected area in hot water at 42-45 0C for 30-90 min, analgesics, tetanus toxoid, and antibiotics. Complications such as soft tissue infection, bone-joint infection, and even tissue necrosis may appear due to the tissue damage of unnoticed fish spines or other foreign bodies. A 36-year-old male patient was admitted to the hospital with complaints of swelling, redness, and hardness on the joint of his middle finger. The patient had a history of a sting by a lionfish while he was swimming a month prior. After consulting with the radiology department, the patient was diagnosed with embedded foreign bodies in the puncture wound. He underwent two surgical repairs and his wound healed without complication. Functional recovery of the affected area of the extremity was achieved by the medical support of a diving physician who is familiar with the health problems related to the marine environment. In addition to the case presentation, we also discuss the history, clinical manifestations, and current treatment for envenomation from this venomous animal. As the population of this species has been increasing, scientists should focus on taking action at a global, regional, national, community, and individual level for solutions. It should be a priority to create awareness and prepare strategies related to prompt diagnosis, initial treatment, and prevention of the injury.