Cnidaria Envenomation Workup

Updated: Apr 27, 2017
  • Author: Spencer Greene, MD, MS, FACEP, FACMT; Chief Editor: Joe Alcock, MD, MS  more...
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Workup

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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