Conidae Clinical Presentation

Updated: Mar 11, 2019
  • Author: David Vearrier, MD, MPH; Chief Editor: Joe Alcock, MD, MS  more...
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A detailed history is essential, when possible, to determine the time of the incident. A typical incident involves walking, swimming, and/or diving in temperate to tropical waters with accidental contact with a cone snail or incorrect handling of a hazardous specimen. If possible, the type of cone should be identified.

Symptoms include the following:

  • Sharp burning or stinging sensation at time of envenomation

  • Local numbness and paresthesias

  • Perioral paresthesias

  • Generalized paresthesias

  • Nausea

  • Blurred vision and diplopia

  • Malaise

  • Generalized weakness

  • Dysphagia

  • Areflexia

  • Aphonia

  • Paralysis

  • Apnea

  • Pruritus

  • Headache


Physical Examination

A patient with a cone snail envenomation may manifest an array of symptoms.

Vital signs should include pulse oximetry.

The envenomed area may become swollen and pale or cyanotic.

A pulmonary examination should assess for respiratory failure and/or respiratory arrest.

A cardiac examination should assess for ectopy and tachycardia.

A detailed neurologic examination should assess for the following:

  • Level of consciousness

  • Visual acuity

  • Motor examination

  • Deep tendon reflexes (decreased/absent)

Serial vital signs and cardiopulmonary and/or neurologic examination are imperative.