(BMJ) - A 14-yo girl presented w/ a swollen, ulcerated 5th toe. Sx began 8 days prior when she felt severe pain in her toe while wading in the English Channel, followed by swelling of her entire lower leg. What is the diagnosis?
Blue jellyfish sting
Stingray envenomation
Weever fish sting
Sea urchin puncture wound
Mycobacterium marinum infection
You are correct. This is a typical weever fish (Echiichthys vipera) sting presentation. This fish inhabits flat, sandy shores and has a heat-labile venom in its dorsal spines. Envenomation leads to pain, swelling, and occasionally systemic disturbances such as cardiac arrhythmias. Emergency tx involves immersing the wound immediately in nonscalding hot water for 30 to 90 min. Chronic pain and Raynaud phenomenon have been reported as complications of weever fish stings.