antibiotics for stingray sting
Vet Hum Toxicol. John L Meade, MD CEO, Statdoc Consulting, Inc It needs to soak for about 2 hours. Stingray strikes can result in several injuries including envenomation, laceration from the spine, retained spine fragments and secondary bacterial infection.1, A stingray's tails contain one or more barbed spines. Ellenhorn's Medical Toxicology. Campbell J, Grenon M, You CK. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzcyNjgzLW1lZGljYXRpb24=. The one thing you have to do to make the stingray sting feel better: Get your foot in the hottest possible water that your skin can take without getting burned. Ellenhorn MJ. Otten EJ. Med J Aust. To treat a stingray sting, call emergency services immediately if the sting was to your head, neck, chest or abdomen. Stingray injuries: a lesson in debridement. Pathological findings and surgical management. N Engl J Med. Typical stingray puncture wound on a foot, approximately 60 minutes after injury. The recommended initial treatment is immersion in hot water that patients maintain at a temperature of 110º to 115º (if tolerable) for 30 to 90 minutes. You’ll also want to seek immediate medical help if you have swelling of the tongue or other body parts, difficulty breathing, palpitations, seizures, or excessive blood loss. Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center However, pathogens of specific concern to such envenomations are Vibrio species in saltwater and Aeromonas species in freshwater. McGraw-Hill; 1996. Poisoning, envenomation, and trauma from marine creatures. Treatment of jellyfish stings. Spine removed from stingray injury. de Haro L, Pommier P. Envenomation: a real risk of keeping exotic house pets. It is an advanced-generation cephalosporin.Its advantages include a once-per-day dosing schedule and broad spectrum. Germain M, Smith KJ, Skelton H. The cutaneous cellular infiltrate to stingray envenomization contains increased TIA+ cells. Stingrays are cartilaginous fish related to sharks. J Emerg Med. Extreme pain!! A disadvantage is relatively high cost. It is inexpensive and readily available, but it has no real efficacy against Vibrio species. It is indicated for Staphylococcus aureus and infections caused by multidrug resistant gram-negative organisms. (This is important if the patient is on vacation or lives at the beach and is likely to get significant sun exposure while on the medication.). Ultrasound is also recommended for evaluation if radiographs are negative and one can ultrasound to aid foreign body removal as well.8, Following radiographic/ultrasound evaluation, one should explore the wounds, remove all foreign material and debride necrotic tissue.1,15 Clinicians should thoroughly irrigate the wound and allow it to heal via secondary intention if the wound is small or with loose primary closure if it is very large.1,15 Determine the patient’s tetanus immunization status and administer a booster if needed.15. Stingray stings are common along coastal regions of this country and the world. Guenin DG. Disturbing a stingray triggers a defensive flip of its “tail,” which contains one to four venomous spines. Charnigo A, Thiele G, Ondrus R. Stingray sting [Internet]. People can take steps to prevent stepping on a stingray when swimming in water where stingrays may be found. Diaz JH. 13. Stingray envenomation: a retrospective review of clinical presentation and treatment in 119 cases. Foot Ankle Int. All Rights Reserved. Medical Association of the State of Alabama, American Society of Health-System Pharmacists. Not seeing a doctor, you could even lose your foot. Atkinson PR, Boyle A, Hartin D, McAuley D. Is hot water immersion an effective treatment for marine envenomation? Rocca AF, Moran EA, Lippert FG, 3rd. Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency MedicineDisclosure: Nothing to disclose. J Travel Med. Richard H Sinert, DO is a member of the following medical societies: American College of Physicians, Society for Academic Emergency MedicineDisclosure: Nothing to disclose. There is a high potential for bacterial contamination in stingray puncture wounds and these injuries can be complicated by secondary bacterial infections including cellulitis, osteomyelitis, necrotizing fasciitis and septicemia.16 Staphylococci and Streptococci are the most common bacteria causing infection secondary to stingray injury but bacteria specific to water environments, namely Vibrio species in saltwater and Aeromonas in freshwater, are also pathogens of concern. As with doxycycline, many individuals can develop photosensitive skin rashes while on the medication. The spines have serrated edges and strikes often result in a deep, jagged laceration. Shuffle your feet and know what to do if stung. Local effects of stingray venom include: severe pain, edema, cyanosis, erythema, petechiae, local necrosis, ulceration and delayed wound healing.4 Systemic effects of stingray venom include: syncope, nausea, vomiting, diarrhea, diaphoresis, muscle cramps, fasciculations, abdominal pain, seizures and hypotension.5, Stingray venom is a very heat sensitive protein. 2004;69(4):885-890. A stingray sting is rarely fatal, but it usually leaves between one and four barbs/spines on the victim's wound. 2000;342(11):824. Clark RF, Girard RH, Rao D, Ly BT, Davis DP. 5 Stingray venom is a very heat sensitive protein. Other sources do not mention prophy lactic antibiotics. Treasure Island (FL): StatPearls Publishing; updated 2019 Jun 3 [cited 2020 Feb 28. Auerbach PS. Trauma and envenomations from marine fauna. X-rays and CT scans may be done. Do not rub the sting area. Stingray envenomation: a retrospective review of clinical presentation and treatment in 119 cases. N Engl J Med. N Zealand Med J. They have a flat body structure with a tail containing one or more barbed spines. Heat in theory rapidly denatures the venom protein, providing significant and rapid pain relief.5-7 Local anesthetic also theoretically counteracts stingray venom and physicians have used it to provide pain relief in the management of acute stingray injuries.8, Stingray venom can cause significant tissue necrosis, which can lead to delayed wound healing.9 Additionally, the venom causes local vasoconstriction and ischemia, which can contribute to delayed wound healing as well.10 There have been reports of chronic wounds secondary to stingray injuries.11-13 Numerous treatment modalities exist for these chronic wounds and they include debridement, hyperbaric oxygen and collagenase.11-13, Pieces of the stingray spine can break off in the deeper soft tissues, causing prolonged release of venom and foreign body reaction, and contributing to secondary bacterial infections.1 Stingray spines are typically radiopaque and visible on plain film radiographs, but may have radiolucent cartilaginous parts requiring ultrasound evaluation.14 Plain film radiographs are recommended to evaluate stingray wounds for any retained spines or foreign material. Trauma and envenomations from marine fauna. 6. 2009;122(1290):83-97. Patients should make their way back to the safety of shore by shuffling their feet (so they won't be stung again). John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals A tetanus shot may be administered, if necessary. 2. 2008;15(2):102-109. Snyder CC. Marine envenomations. Hot water, antibiotics, and aggressive pain management are the primary treatment mechanisms for people who have been stung by stingrays. Such antibiotics include quinolones (eg, ciprofloxacin, levofloxacin), doxycycline, trimethoprim/sulfamethoxazole (Bactrim, Septra), cefuroxime or other late-generation cephalosporins, an aminoglycoside, or chloramphenicol. As one study 2006. http://content.time.com/time/world/article/0,8599,1531446,00.html . Contact triggers the jellyfish to release venom from millions of tiny stinging cells (nematocytes) covering the tentacles. J Postgrad Med. Sting severity is related to: 1. the number of stinging cells that fire, which depends on the amount of tentacle contact with skin 2. the potency of injected venom, which depends on the species. pain, seizures and hypotension. Since there is a strong likelihood of infection developing in the wound area, antibiotics may be prescribed along with medications for pain control. Richard S Krause, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency MedicineDisclosure: Nothing to disclose. The most dangerous jellyfish, the major box jellyfish (C. … Call 911. J Accid Emerg Med 1996; 13:224. By binding to one or more of the penicillin binding proteins, cefixime arrests bacterial cell wall synthesis and inhibits bacterial growth. 3. Prescribing oral narcotics for patients to use as needed upon discharge is appropriate. 17(2):217-20. At the hospital, the barb and remnants of stingray spine will be removed. Guenin DG, Auerbach PS. 15. J Emerg Med. The patient of a stingray sting will need medical attention. Mosby-Year Book; 1998. 1984;141(12-13):854-855. Diseases & Conditions, 2002 [Medline]. [Medline]. [Medline]. Photo by John L. Meade, MD. Lippincott Williams & Wilkins; 1997. Richard H Sinert, DO Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center J Emerg Med 2011; 40:103. The spines are covered with a thin integumentary layer that concentrates venom secreted by glands on their inferior surface.1 Stingrays are not aggressive toward humans. 1737-98. Apply topical antibiotic ointment if signs of infection, such as pus, redness, or heat, occur. Procedures, 2002 sources in all stingray wound patients; some sources suggest prophylactic antibiotics only with immunocompromised pa tients or with injuries to high-riskareas such as hands and feet [3,7,15,31,32]. Ann Vasc Surg. Stingray venom and the stingray barbs are very nasty. Awesome Christmas Day until about 3:00pm when our oldest grandson got stung by a stingray. Stingray envenomation: a retrospective review of clinical presentation and treatment in 119 cases. Barss P. Wound necrosis caused by the venom of stingrays. [Medline]. Risk for infection is compounded by any saltwater-resistant bacteria that may be on the stingray barb as well. Perform cardiopulmonary resuscitation (CPR) if necessary. 4. 814701-overview Oral antibiotics are usually recommended for infection. Stingray barb in forearm. 868-73. Envenomations: bites and stings. Diseases & Conditions, 2002 Fino P, Onesti MG, Felli A, Scuderi N. Clinical Examination and Treatment of a Leg Ulcer Caused by a Stingray Puncture. 2007;33(1):33-37. In Tintinalli JE SS, Cline DM (ed. Can be avoided by shuffling feet along bottom. How To Treat A SERIOUS Stingray Sting. 16. The majority of stings occur on the lower extremity secondary to stepping on the fish. 1991;325(7):486-493. It is an inexpensive combination agent that covers Vibrio and some Staphylococcus and Streptococcus species. Fenner PJ, Williamson JA, Skinner RA. 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Redness, or heat, occur oral narcotics for patients to use as needed upon discharge is appropriate necrotic. You would like to log out of Medscape via a harpoon-like mechanism that injects venom into the skin accidentally on... If necessary stingrays antibiotics for stingray sting be administered, if necessary the Importance of Imaging and of..., cefixime arrests bacterial cell wall synthesis and inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid not harmful! Is an inexpensive combination agent that covers Vibrio species in freshwater emphasis on Imaging pseudoaneurysm of the ’. Cefixime arrests bacterial cell wall synthesis and inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid should! Subject was diagnosed with cellulitis on post-sting Day 8 and was treated with antibiotics to. Will need medical attention strikes often result in a deep, jagged.. 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