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Cnidaria Envenomation Workup

  • Author: Spencer Greene, MD, MS, FACEP; Chief Editor: Scott H Plantz, MD, FAAEM  more...
 
Updated: Feb 03, 2015
 

Laboratory Studies

No specific laboratory studies exist for Cnidaria envenomations. In severely symptomatic patients, laboratory tests should be obtained to identify any end-organ damage or to diagnose or exclude conditions that may mimic an envenomation. The following tests are recommended:

  • Serum glucose level
  • Complete blood cell count
  • Arterial blood gases analysis
  • Electrolyte levels
  • Blood urea nitrogen level
  • Creatinine level
  • Thyroid stimulating hormone
  • Urinalysis
  • Creatinine phosphokinase level
  • Troponin

Nematocysts may be identified by microscope from scalpel-blade scrapings of the sting site or sticky-tape sampling. These techniques generally demonstrated good specificity, and both appear to be equal in terms of nematocyst retrieval. However, C barnesi nematocysts have traditionally been difficult to harvest from the sting site.

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Imaging Studies

Radiographs of the affected extremity are unnecessary, but a chest radiograph is recommended in patients with significant cardiopulmonary signs or symptoms.

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Other Tests

An electrocardiogram is recommended in severe envenomations to detect any cardiotoxic effects of the envenomation and to identify or exclude other conditions in the differential diagnosis.

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Contributor Information and Disclosures
Author

Spencer Greene, MD, MS, FACEP Director of Medical Toxicology, Assistant Professor of Medicine, Assistant Professor of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine

Spencer Greene, MD, MS, FACEP is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, East Texas Herpetological Society, Texas College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

A Antoine Kazzi, MD Deputy Chief of Staff, American University of Beirut Medical Center; Associate Professor, Department of Emergency Medicine, American University of Beirut, Lebanon

A Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Scott H Plantz, MD, FAAEM Associate Clinical Professor of Emergency Medicine, Department of Emergency Medicine, University of Louisville School of Medicine

Scott H Plantz, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Dana A Stearns, MD Assistant Director of Undergraduate Education, Department of Emergency Medicine, Massachusetts General Hospital; Associate Director, Undergraduate Clerkship in Surgery, Massachusetts General Hospital/Harvard Medical School; Assistant Professor of Surgery, Harvard Medical School

Dana A Stearns, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Acknowledgements

G Patrick Daubert, MD Assistant Professor, Assistant Medical Director, Sacramento Division, California Poison Control System; Director of Clinical and Medical Toxicology Education, Department of Emergency Medicine, University of California, Davis Medical Center

G Patrick Daubert, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Medical Toxicology, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Allison J Richard, MD Assistant Professor of Emergency Medicine, Keck School of Medicine of the University of Southern California; Associate Director, Division of International Medicine, Attending Physician, Department of Emergency Medicine, LAC+USC Medical Center

Disclosure: Nothing to disclose.

Chanida Sintuu, MD Resident Physician, Department of Emergency Medicine, LAC+USC Medical Center

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Merck, Salary, Employment

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Cnidaria and jellyfish envenomations. Close-up photograph of sea anemone demonstrating tentacles surrounding the central mouth structure. Contact with tentacles results in discharge of nematocysts. Photo courtesy of Scott A. Gallagher, MD.
Cnidaria and jellyfish envenomations. Close-up photograph of a sea anemone demonstrating one of several tentacle types observed among different species. Photo courtesy of Scott A. Gallagher, MD.
 
 
 
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