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Scorpion fish sting

Scorpion fish are members of the family Scorpaenidae, which includes lionfish and stonefish. These fish are particularly good at camouflaging themselves in their surroundings. The fins of these prickly fish carry poisonous venom. This article describes the effects of a sting from such fish.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

  • Scorpion fish venom

Where Found

Scorpion fish live in tropical waters, including the warm shorelines of the coastal United States. They are also considered prized aquarium fish and thus are found worldwide.

  • Scorpion fish
  • Related species

Symptoms

A scorpion fish sting causes intense pain and swelling at the site of the sting. Swelling can spread to affect an entire arm or leg within minutes.

Airways and lungs:

  • Difficulty breathing

Heart and blood:

  • Collapse

Skin:

  • Bleeding
  • Severe pain at the site of the sting
  • Whitened color of the area around the site of the sting
  • Color of the area changes as the amount of oxygen supplying the area decreases

Stomach and intestines:

  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting

Nervous system:

  • Delirium
  • Fainting
  • Fever (from infection)
  • Headache
  • Muscle twitching
  • Seizures
  • Paralysis

Home Care

Seek immediate medical attention.

Wash the area with salt water. Remove any foreign material at the wound site. Soak the wound in the hottest water the person can tolerate for 30 to 90 minutes while contacting your local emergency services.

Before Calling Emergency

Determine the following information:

  • Patient's age, weight, and condition
  • Time of the sting
  • Location of the sting

Poison Control

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound will be soaked in a cleaning solution and any remaining foreign material will be removed. Symptoms will be treated as appropriate, and some or all of the following procedures may be performed:

  • Blood and urine tests
  • Breathing assistance
  • X-rays
  • EKG (electrocardiogram, or heart tracing)
  • Fluids through a vein (by IV)
  • Medication (antiserum) to reverse the effect of the venom
  • Medication to treat symptoms
  • X-rays
  • Tetanus shot, if necessary

Outlook (Prognosis)

Outcome often depends on how much poisonous venom entered the body, the location of the sting, and how soon treatment is received. Numbness or tingling may persist for several weeks after the sting. Skin breakdown is sometimes severe enough to require surgical treatment.

A puncture to the patient's chest or abdomen may lead to death.

Prevention

If scuba diving or snorkeling, learn to identify potentially poisonous or otherwise dangerous sea creatures and their habits.

References

Simon B, Hern HG Jr. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 56.

Isbister GK, Caldicott DG. Trauma and evenomations from marine fauna. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 196.

Auerbach PS. Envenomation by Aquatic Vertebrates. In: Auerbach PS, ed. Wilderness Medicine. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2011:chap 81.

Updated: 10/18/2013

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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