Symptoms and Signs of Scorpionfish, Lionfish, and Stonefish Poisoning

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 11/3/2021

Doctor's Notes on Scorpionfish, Lionfish, and Stonefish Poisoning

Scorpionfish, lionfish, and stonefish are poisonous fish that live in tropical and temperate oceans and are commonly found in the Red Sea and Indian and Pacific oceans. All these fish have sharp, venomous, erectile spines on their dorsal, anal, and pelvic fins. Contact with these spines can cause the venom to enter a person’s bloodstream. These fish are not aggressive so poisonings are usually accidental or due to inappropriate handling of the fish.

Symptoms of scorpionfish, lionfish, and stonefish poisoning vary from person to person, and depend on the amount of toxin a person is exposed to. Symptoms of scorpionfish, lionfish, and stonefish poisoning include intense throbbing pain that peaks in 1 to 2 hours and lasts 12 hours. Pain may be severe and could cause hallucinations.

Other symptoms of poisoning include

  • redness,
  • bruising,
  • swelling,
  • numbness,
  • tingling,
  • blisters, and
  • tissue shedding at the wound site.

Severe reactions include

What Is the Treatment for Scorpionfish, Lionfish, and Stonefish Poisoning?

Stings causing scorpionfish, lionfish, and stonefish poisoning can vary in symptoms from mild to deadly. It is important to seek medical care right away. The pain may be quite severe and debilitating requiring medical intervention.

Things to do immediately after a sting from a scorpionfish, lionfish, or stonefish include: 

  • Remove the victim from the water 
  • Immerse the wound for 30 to 90 minutes in water as hot as the victim can tolerate because the poisons are heat-sensitive and deactivate in heat
  • Use tweezers to remove any spines in the wound, using caution to not squeeze venom glands that may have broken off in the wound with the spine
  • Scrub the wound with soap and water and flush the affected area with lots of fresh water
  • Get to a medical facility as there is antivenom available for stonefish poisoning
  • Local or regional anesthetics (blocks) may be useful in some patients for pain control
  • Narcotic pain medications may be needed for pain control
  • Patients in shock may need critical cardiac monitoring, medications for shock, and possibly admission to the hospital for further care
  • Patients may need a tetanus booster
  • Patients with large wounds may need antibiotic treatment

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.