Identification of Chironex fleckeri envenomation by nematocyst recovery from skin

Abstract

To prospectively compare two methods of nematocyst retrieval from skin for confirmation of Chironex fleckeri jellyfish envenomation. Twenty patients presenting to Royal Darwin Hospital with jellyfish stings. In each, two methods of retrieval of nematocysts from the sting site were tested: scraping the skin with a scalpel blade; and application of transparent sticky tape. Chironex fleckeri nematocysts were identified in 14/20 patients by scalpel blade scraping and in 17/20 by the sticky tape method. In all patients with scalpel blade scrapings positive for nematocysts, nematocysts were also retrieved by the sticky tape method. Only four patients required narcotic analgesia and none required C. fleckeri antivenom. Nematocyst retrieval from skin by a simple sticky tape method is at least as good as scraping with a scalpel blade. Chironex fleckeri causes the majority of jellyfish envenomations presenting to Royal Darwin Hospital.