What are the other Names for this Condition? (Also known as/Synonyms)

• Sting of the Stonefish

What is Stonefish Sting? (Definition/Background Information)

• The stonefish is the most venomous fish of the world. It ranges in size from 30-45 cm. It is a predatory animal that blends well amongst the sea floor. The tropical and temperate waters of the Indian and Pacific oceans are its main habitat
• The fish is covered in prickly spines that carry highly toxic venom. Stonefish generally reside at the bottom of the (shallow-part of the) ocean and capture prey (other fish) through camouflage. They are called ambush predators and can sit motionless for long durations waiting for their prey to get closer
• Contact with humans occurs mostly during swimming or wading in shallow waters (accidental contact). Stonefish do not attack humans, but can inflict painful stings with the release of potent venom, when they are stepped upon. Their venom is fast-acting and can cause delirium and paralysis in a short period of time
• The signs and symptoms of the Stonefish Stings are often severe and it depends on the amount of toxin injected and the reaction of the human body to the toxin
• Immediate medical attention has to be sought for all stings. The treatment would involve removal of the spines, washing the affected area, and use of medications (topical antibiotics and painkillers). The prognosis is generally good with early and appropriate treatment

Who gets Stonefish Sting? (Age and Sex Distribution)

• Any individual exposed to the stonefish is vulnerable to its sting
• Both males and females are affected and there is no gender bias observed
• Stonefish are marine creatures found mostly in the Indian and Pacific oceans
• Many cases of Stonefish Stings have been reported from Australia

What are the Risk Factors for Stonefish Sting? (Predisposing Factors)

The risk factors identified for Stonefish Stings include:

• Swimmers, surfers, divers, and beachgoers
• Coral reef divers
• Wading in ocean waters without suitable protective clothing
• Walking barefoot on the beach or in shallow sea water
• Keeping them as pets in aquariums (exotic collection)
• Handling dead or live stonefish species
• Since these creatures resemble rough stones or corals, they may be picked up by unsuspecting swimmers or divers

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Stonefish Sting? (Etiology)

• Stonefish Stings release a very poisonous chemical into the human skin through their spine, which can severely affect the human body
• Depending on the amount of poison injected, the severity of the signs and symptoms is dictated

What are the Signs and Symptoms of Stonefish Sting?

The severity of signs and symptoms of Stonefish Sting depends on the following factors:

• The type or species of stonefish
• The amount of toxin injected
• The reaction of the human body to the toxin

The signs and symptoms of Stonefish Sting may be mild or severe and may include:

• Severe stinging pain lasting for several hours
• Rashes on the skin (red-colored welts), bruising
• Swelling of the wound
• Blister formation
• Headaches
• Abnormal heart rate, reduced blood pressure
• Allergic shock or reaction, in some cases
• Shortness of breath; breathing difficulties
• Muscle cramps, abdominal cramps
• Nausea, vomiting, and diarrhea
• Severe fatigue
• Unconsciousness

How is Stonefish Sting Diagnosed?

A Stonefish Sting is diagnosed through the following tools:

• A physical examination of the affected site by the physician is normally sufficient to diagnose the condition
• In addition, the symptoms exhibited by the individual may be carefully observed
• The individual may be asked to provide an account (history) of the events that occurred (what took place and how)
• Blood tests consisting of complete blood count (CBC) and electrolytes

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Stonefish Sting?

The complications that may arise from a Stonefish Sting may include:

• Bleeding and skin ulceration can cause secondary bacterial or fungal infections to develop
• The toxin can affect several systems of the body (systems of the heart, lungs, nerves, gastrointestinal tract, etc.)
• Anaphylaxis type allergic reaction
• Respiratory distress
• Reduced heart rate, heart failure
• Delirium and shock
• Paralysis

Untreated Stonefish Stings are known to result in fatalities. The effect of the toxin can be very severe in children, older adults, and individuals with poor immunity.

How is Stonefish Sting Treated?

The treatment measures for Stonefish Sting may include:

• The first line of treatment is often to remove the stingers/spines by gently pulling them out with a pair of tweezers; breaking the spines must be avoided
• The use of very hot water can help reduce the potency of the venom, and hence, the wound is soaked for up to an hour in hot water. This can also help reduce the pain intensity
• Once the spines are removed, the affected area is washed with soap and fresh water
• The wound is left uncovered to heal
• Topical antiseptics may help prevent wound infection
• Pain relieving medications (acetaminophen) as required
• Administration of antivenom (antivenin)
• Tetanus vaccination is usually required, if it is not up to date
• In case of severe stings, it could be a medical emergency and prompt attention has to be provided. The treatment measures may include:
  • CPR may be provided as necessary, breathing assistance
  • Stabilizing the blood pressure
  • Pain control medications, steroids
• Proper follow-up care and check-ups may be required, especially to monitor for any signs of infection

Note: It is always important to call the local emergency helpline number (911 in the US) without any delay.

How can Stonefish Sting be Prevented?

The following factors may be considered to reduce the incidence of Stonefish Stings:

• Do not ignore warnings of lifeguards or health officials at the beach
• Avoid making an attempt to touch or handle marine animals unnecessarily
• Wear protective clothing if you plan to swim or dive in infested areas (suitable wet skin or diver’s suit)
• Generally be aware or watchful of the waters you are in (to the extent possible)
• Wear protective footwear while walking on beach sand
• When removing stingers from the body, wear suitable protective cover (such as hand gloves); avoid removing the sting with bare hands
• Avoid rubbing the stung area with bare (unprotected) hands
• Ensure safety precautions while cleaning marine animal aquariums; wear gloves
• Marine life explorers and sea adventurers are required to carry marine first aid kit

What is the Prognosis of Stonefish Sting? (Outcomes/Resolutions)

• The prognosis of Stonefish Sting is generally good with early and effective treatment
• However, severe stings combined with delayed treatment can be life-threatening and result in death

Additional and Relevant Useful Information for Stonefish Sting:

The scorpionfish, lionfish, and stonefish are grouped under the same biological family of Scorpaenidae.