Doctor's Notes on Weever Fish Sting: Pain, Symptoms, and Treatment
A weeverfish (mud-dwelling 4- to 21-inch-long fish with venom containing four to eight sharp spines on its back) sting occurs from direct skin contact (puncture) with extendable venom-containing spines. The spines can penetrate through a leather boot. Signs and symptoms include immediate severe burning and crushing-like pain and swelling that can radiate through the stung extremity. It peaks at about 30 minutes and gradually resolves, but in some people, the pain can persist for days. Systemic symptoms and signs may include
Some individuals can exhibit serious problems such as
- low blood pressure,
- arrhythmias,
- difficulty breathing, and
- death (though uncommon).
Infections of the sting site are common.
The cause of the weeverfish sting is the puncture wound and venom from the fish spines. This fish is the most venomous fish in the Black Sea, Mediterranean Sea, Eastern Atlantic Ocean, North Sea, and European coastal areas and has several other names (sea dragon, sea cat, for example). Usually, the sting is triggered by a person inadvertently stepping on the fish buried in the muddy or sandy coastal waters.
What Are the Treatments for a Weeverfish Sting?
Weeverfish stings can be treated by this protocol:
- Immerse sting area in water as hot as the person can stand it for about 30-90 minutes. Repeat this as necessary for pain control.
- Remove all the spines from the wound with tweezers.
- Scrub the wound with soap and water, and then rinse with a lot of water.
- Leave the wound open.
- Apply hydrocortisone topical cream to reduce any itching.
- Take over-the-counter pain medicine.
- Look for signs of infection such as redness, heat, and exudate (rarely infected). You may need a tetanus shot.
- Apply topical ointment and/or antibiotics if the wound becomes infected.
Some people may be allergic to the sting. Be vigilant to treat allergic reactions quickly to avoid a patient needing cardiopulmonary resuscitation.
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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.