Weeverfish Sting Overview
The weeverfish is the most venomous fish found in the Black Sea, Mediterranean Sea, Eastern Atlantic Ocean, North Sea, and European coastal areas. It is often referred to as the sea dragon, sea cat, stang, and adder-pike.
Weeverfish are small (4 to 21 inches) long, and usually live in the sand or mud, often burying themselves, along coastal areas. They are usually docile, however when provoked can strike with pinpoint accuracy.
Weeverfish inject their venom from long "spines" that number from four to eight, and are needle sharp along the back of the fish. Each spine can measure up to 1 ¾ inches in length. When provoked to attack, they extend these spines to strike at prey.
Weeverfish can survive for extended times (hours) out of the water and the venom can still be active for hours as well in dead animals.
Weeverfish Sting Symptoms
Professional fishermen or vacationers are often those that receive the sting from a weeverfish. Envenomation often occurs when wading in sandy, muddy coastal waters or swimming, and accidental contact or threat to the fish occurs inviting the sting to occur.
The spine of the fish is strong enough to penetrate through a leather boot.
The pain of the sting is instant, and described and burning and crushing and can spread to involve the entire leg (or arm) from where the puncture occurred. Pain typically peaks at 30 minutes then resolves by 24 hours, but can persists for many days. The puncture site itself can show redness, bruising and warmth over a 6 to 12 hour time period. Swelling can increase in the affected limb for up to a week. Infections are common due to the depth of the puncture and the "dirty" nature of the puncture from murky, sandy or muddy water. There also have been cases of gangrene due to infection.
Occasionally, a wound is left at the site of the puncture that can take months to heal.
While symptoms of the weeverfish sting occur at the site itself, total body (also called systemic) symptoms can occur such as fever, chills, seizures, fainting (syncope), nausea, low blood pressure, cardiac arrhythmia (irregular or extra heart beats), headaches, sweating, and difficulty breathing.
While not common, death can occur due to complications from the venom.
Scott D. Fell, DO, FAAEM