Clinical Flowchart
Autopharmacological effects
Not observed.
Local effects
| All venomous fish | ||
| Puncture wound | ||
| Stingrays, (Catfishes) | All other venomous fish | |
| Deep injuries; penetration of organs, pleural, pericardial and abdominal cavities
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| Strong (unbearable) pain | ||
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| Local swelling, possibly extensive | ||
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| Skin necrosis | ||
| Deep necrosis, including internal organs | ||
| Physical destruction of vessels, nerves, tendons etc. | ||
Haematological effects
Not observed.
Neurological effects
| Stonefishes
Other venomous fish probable |
| Cardiac and neurological, including autonomous effects1 |
| 1 | Signs and symptoms such as nausea, vomiting, diarrhoea, hypersalivation, hypotension, cardiac arrhythmias, cardiac arrest, respiratory distress, pulmonary oedema and muscle paralysis are listed in various combinations in case reports of venomous fish accidents.
However, in encounters with different venomous fish species, it remains to various degrees controversial how much secondary effects play a role in the overall picture such as responses related to intense/agonizing pain, circumstancial effects, e.g. near drowning. Age and underlying preexisting health condition most likely also contribute to the outcome reported. Given the uncertainties about systemic envenoming in accidents caused by various venomous fish, systemic venom induced cardiac effects and neurological, including autonomous effects, are presented together. |
Muscular effects
Not observed.
Cardiac effects
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| Cardiac and neurological, including autonomous effects |
| 1 | Signs and symptoms such as nausea, vomiting, diarrhoea, hypersalivation, hypotension, cardiac arrhythmias, cardiac arrest, respiratory distress, pulmonary oedema and muscle paralysis are listed in various combinations in case reports of venomous fish accidents.
However, in encounters with different venomous fish species, it remains to various degrees controversial how much secondary effects play a role in the overall picture such as responses related to intense/agonizing pain, circumstantial effects, e.g. near drowning. Age and underlying preexisting health condition most likely also contribute to the outcome reported. Given the uncertainties about systemic envenoming in accidents caused by various venomous fish, systemic venom induced cardiac effects and neurological, including autonomous effects, are presented together. |
Renal effects
Not observed.