MARINE TOXINS AND VENOMOUS AND POISONOUS MARINE ANIMALS
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redness, itching, pain and the vascular changes-may be attributable
to the 6-HT, histamine and histamine-releasing substances.
C. Clinical problem
It has long been known that the nematocysts of certain cnidarians
can penetrate the human skin. Of such nematocysts, most are capable
of penetrating only the thin membranes of the mouth, tongue or
conjunctiva, but some possess sufficient force to pierce the skin of the
inner sides of the arms and hands, and sometimes even the thicker
surfaces of the body.
The cutaneous lesions produced by nematocysts may vary considerably. The fire, or stinging, corals (Milkpora) produce small
reddened, somewhat papular eruptions, which appear 1 to 10 h following
the contact, and usually subside within 24 to 96 h. In severe cases the
papules may proceed to pustular lesions and desquamation. The
stinging is usually associated with some localized pain, generally of
short duration. Pruritus is common.
The lesions produced following contact with the Portuguese manof-war (Physuliu) appear as small papular eruptions in one or several
discontinuous lines which may sometimes encircle the extremity or
injured part. Each papule may be surrounded by an erythematoua
zone. In some cases the papules may be very close together, indicating
that multiple discharge of the nematocysts took place as the tentacle
passed over the injured part. The papules develop rapidly and often
increase in size during the first hour following the stinging. Pain is
often present and in some cases may be very severe. While it usually
tends to be localized, it may spread to involve the entire injured
extremity as well as the adjacent lymph nodes. In some cases the
papules may vesiculate and proceed to pustulation and desquamation.
I have seen several cases in which multiple areas of hyperpigmentation
could be found over the involved part several years following the stinging. Joint and muscle pains are not uncommon and may persist for a
number of hours following the injury.
General systemic manifestations may also develop following
Physuliu envenomation. Weakness, nausea, headache, pain and spasms
in the large muscle masses of the abdomen and back, lacrimation and
nasal discharge, increased perspiration, and vertigo have been reported
in many cases. Difficulty and pain on respiration, changes in pulse rate
and severe muscle spasms have been reported in the more severe cases.
Contact with the true jellyfishes gives rise, in the less severe cmes,
to symptoms and findings similar to those noted above. I n the more
severe cases there is immediate, intense, burning pain. The lines of
281
redness, itching, pain and the vascular changes-may be attributable
to the 6-HT, histamine and histamine-releasing substances.
C. Clinical problem
It has long been known that the nematocysts of certain cnidarians
can penetrate the human skin. Of such nematocysts, most are capable
of penetrating only the thin membranes of the mouth, tongue or
conjunctiva, but some possess sufficient force to pierce the skin of the
inner sides of the arms and hands, and sometimes even the thicker
surfaces of the body.
The cutaneous lesions produced by nematocysts may vary considerably. The fire, or stinging, corals (Milkpora) produce small
reddened, somewhat papular eruptions, which appear 1 to 10 h following
the contact, and usually subside within 24 to 96 h. In severe cases the
papules may proceed to pustular lesions and desquamation. The
stinging is usually associated with some localized pain, generally of
short duration. Pruritus is common.
The lesions produced following contact with the Portuguese manof-war (Physuliu) appear as small papular eruptions in one or several
discontinuous lines which may sometimes encircle the extremity or
injured part. Each papule may be surrounded by an erythematoua
zone. In some cases the papules may be very close together, indicating
that multiple discharge of the nematocysts took place as the tentacle
passed over the injured part. The papules develop rapidly and often
increase in size during the first hour following the stinging. Pain is
often present and in some cases may be very severe. While it usually
tends to be localized, it may spread to involve the entire injured
extremity as well as the adjacent lymph nodes. In some cases the
papules may vesiculate and proceed to pustulation and desquamation.
I have seen several cases in which multiple areas of hyperpigmentation
could be found over the involved part several years following the stinging. Joint and muscle pains are not uncommon and may persist for a
number of hours following the injury.
General systemic manifestations may also develop following
Physuliu envenomation. Weakness, nausea, headache, pain and spasms
in the large muscle masses of the abdomen and back, lacrimation and
nasal discharge, increased perspiration, and vertigo have been reported
in many cases. Difficulty and pain on respiration, changes in pulse rate
and severe muscle spasms have been reported in the more severe cases.
Contact with the true jellyfishes gives rise, in the less severe cmes,
to symptoms and findings similar to those noted above. I n the more
severe cases there is immediate, intense, burning pain. The lines of