Octopus Envenomation Clinical Presentation

  • Author: Jon Mark Hirshon, MD, MPH; Chief Editor: Scott H Plantz, MD, FAAEM   more...
 
Updated: Jun 20, 2011
 

History

Any octopus can bite with its parrot-like chitinous beak.

The bite of the blue-ringed octopus is usually painless; however, the individual may experience a reaction similar to a bee sting.

If envenomation has occurred, symptoms are likely to start within 10 minutes of being bitten.

If a significant envenomation has occurred, the individual will rapidly progress from perioral and peripheral paresthesias through the following signs and symptoms.

  • Nausea and vomiting
  • Blurred vision
  • Ataxia
  • Muscle paralysis
  • Respiratory failure, which may lead to cardiac arrest and death

Anaphylactoid or anaphylactic reactions have rarely been reported.

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Physical

The individual is usually bitten on an extremity and sustains 1-2 small puncture wounds.

Local reaction may be minimal, but it can progress to include pain, edema, and erythema of the entire extremity.

The patient becomes flaccid once paralyzed.

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Causes

Envenomations usually occur when an individual picks up a blue-ringed octopus or accidentally steps on one.

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Contributor Information and Disclosures
Author

Jon Mark Hirshon, MD, MPH  Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine

Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Dana A Stearns, MD  Assistant Director of Undergraduate Education, Department of Emergency Medicine, Massachusetts General Hospital

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

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

James Steven Walker, DO, MS  Clinical Professor of Surgery, Department of Surgery, University of Oklahoma College of Medicine

James Steven Walker, DO, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, and American Osteopathic Association

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Scott H Plantz, MD, FAAEM  Associate Clinical Professor of Emergency Medicine, Rosalind Franklin University of Medicine and Science, Chicago Medical School; Medical Director, WeCare Med, Inc

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

Disclosure: Nothing to disclose.

References

  1. Walker DG. Survival after severe envenomation by the blue-ringed octopus (Hapalochlaena maculosa). Med J Aust. Dec 10-24 1983;2(12):663-5. [Medline].

  2. Flachsenberger WA. Respiratory failure and lethal hypotension due to blue-ringed octopus and tetrodotoxin envenomation observed and counteracted in animal models. J Toxicol Clin Toxicol. 1986-87;24(6):485-502. [Medline].

  3. Kizer KW. Marine envenomations. J Toxicol Clin Toxicol. 1983-84;21(4-5):527-55. [Medline].

  4. Auerbach PS. Marine envenomations. N Engl J Med. Aug 15 1991;325(7):486-93. [Medline].

  5. McGoldrick J, Marx JA. Marine envenomations. Part 2: Invertebrates. J Emerg Med. Jan-Feb 1992;10(1):71-7. [Medline].

  6. Nimorakiotakis B, Winkel KD. Marine envenomations. Part 2--Other marine envenomations. Aust Fam Physician. Dec 2003;32(12):975-9. [Medline].

  7. Fernandez I, Valladolid G, Varon J, Sternbach G. Encounters with venomous sea-life. J Emerg Med. Jan 2011;40(1):103-12. [Medline].

  8. Oda K, Araki K, Totoki T, et al. Nerve conduction study of human tetrodotoxication. Neurology. May 1989;39(5):743-5. [Medline].

  9. Watters MR, Stommel EW. Marine Neurotoxins: Envenomations and Contact Toxins. Curr Treat Options Neurol. Mar 2004;6(2):115-123. [Medline].

  10. Chang FCT, Spriggs DL, Benton BJ, et al. 4-Aminopyridine reverses saxitoxin (STX)- and tetrodotoxin (TTX)- induced cardiorespiratory depression in chronically instrumented guinea pigs. Fundam Appl Toxicol. Jul 1997;38(1):75-88. [Medline].

 
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Blue-ringed octopus. Image courtesy of Simon Dubbin.
 
 
 
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