Doctor's Notes on Cone Snail Sting
Cone snails have cone-shaped shells, a head, and tentacles. Venomous cone snails are found in the Indian and Pacific oceans, the Caribbean and Red seas, and along the coast of Florida. The toxin from cone snails in the Indo-Pacific region tends to be more harmful than other regions of the world. Cone snails are not aggressive. Cone snail stings usually occur when divers in deep reef waters handle the snails. Swimmers and snorkelers are unlikely to find cone snails in shallow intertidal waters.
Symptoms of cone snail stings may begin within minutes or can take days to appear and are similar to a wasp or bee sting with localized burning and sharp stinging symptoms. Stings can be intense and there may be numbness and tingling to the wounded area. Other symptoms of cone snail stings include
- blueness at the site due to decreased blood flow (cyanosis),
- numbness or tingling involving an entire limb,
- fainting,
- itching,
- loss of coordination,
- heart failure,
- difficulty speaking,
- difficulty breathing, and
- double vision.
Severe cases of cone snail stings include
- total limb numbness that progresses to the area around the mouth and the entire body.
- Paralysis can occur leading to paralysis of the diaphragm, which stops the ability to breathe and can result in coma or death.
What Is the Treatment for Cone Snail Stings?
Cone snail stings can be life-threatening and victims of a cone snail sting should seek medical care immediately. The severity of the sting depends on the amount of venom injected and the size of the victim. Stings are often very painful and supportive medical care is necessary. In cases of severe envenomation, nerve dysfunction, paralysis, and death can occur.
There is no specific anti-venin for cone snail stings. Treatment is focused on symptoms and may include:
- Over-the-counter (OTC) pain medications such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil)
- Intravenous narcotic pain medications such as morphine
Victims should be monitored closely for signs of paralysis (trouble speaking, trouble breathing, double vision, or numbness of the extremity that was stung) as these patients may need to be placed on a ventilator to assist with recovery.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.