An outbreak of Portuguese man-of-war (Physalia physalis - Linnaeus, 1758) envenoming in Southeastern Brazil

Introduction Portuguese man-of-war, Physalia physalis (Linnaeus, 1758), are cnidarians capable of discharging intracellular organelles filled with venom, resulting in severe envenomation in humans. Methods We report the clinical and therapeutic aspects of 331 accidents involving Portuguese man-of-war in an outbreak on the coast of the State of São Paulo, Brazil. Results The clinical manifestations of envenomation were rare and mild and mostly local, systemic reactions; there was a low rate of late complications. Conclusions The consequences of envenomation were of moderate severity, and first aid measures were effective in controlling the pain. Outbreaks of accidents involving Portuguese man-of-war occur periodically in the area without a clear explanation. .

Emergencia hipertensiva en emponzoñamiento escorpiónico pediátrico: reporte de un caso / Hipertensive emergency in pediatric scorpion envenomation: case report

Se reporta el caso clínico de una niña de 2 años, quien posterior a picadura por escorpión en el brazo izquierdo, presentó náuseas, vómitos, sialorrea e hipertensión arterial, a pesar de la administración precoz de suero antiescorpiónico y captopril. Al día siguiente, debido a la emergencia hipertensiva, desarrolló varias crisis convulsivas tónicas generalizadas, refractarias a diazepam y controladas con difenilhidantoína en infusión por 24 horas; la emergencia hipertensiva se prolongó por 10 días y se trató con captopril, nifedipina y carvedilol por vía oral. Este cuadro clínico se acompañó con miocarditis, pancreatitis y una reacción adversa medicamentosa a la antivenina escorpiónica. Otros fármacos administrados fueron corticoesteroides, midazolam y fentanilo. La evolución fue satisfactoria y la niña fue egresada en buenas condiciones generales dos semanas después del ingreso. Este caso se muestra con características infrecuentes como la concomitancia de los patrones miocárdico y cardiovascular, la severidad del patrón vascular, la duración de la emergencia hipertensiva, la falta de efectividad de captopril y del suero antiescorpiónico y la reacción adversa a la antivenina.

We report the clinical case of a 2 year old girl, who developed nausea, vomiting, increased salivation and arterial hypertension, after ascorpion sting in her left arm, despite the early administration of scorpion antivenom and captopril. Next day, due to a hypertensive emergency, the patient developed generalized tonic seizures, refractory to diazepam, which were controlled with an infusion of dyphenilhydantoine for 24 hours. The hypertensive emergency extended for 10 days and was treated with oral captopril, nifedipine and carvedilol. This clinical picture was accompanied with myocarditis, pancreatitis and an adverse drug reaction to the anti venom. Other drugs administered were corticosteroids, midazolam and fentanyl. The Outcome was satisfactory and the girl was discharged in good general conditions, two weeks after admission. This case appears with uncommon features, such as the occurrence of myocardic and cardiovascular patterns, severity of vascular pattern, the duration of the hypertensive emergency, ineffectiveness of captopril and the scorpion antivenom, and the adverse reaction to antivenin.

Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): etiology and severity of accidents on the Brazilian coast / Lesões dermatológicas observadas nos acidentes por cnidários (águas-vivas e caravelas): etiologia e gravidade dos envenenamentos no litoral do Brazil

This work attempts to establish dermatological identification patterns for Brazilian cnidarian species and a probable correlation with envenoming severity. In an observational prospective study, one hundred and twenty-eight patients from the North Coast region of São Paulo State, Brazil were seen between 2002 and 2008. About 80 percent of these showed only local effects (erythema, edema, and pain) with small, less than 20 cm, oval or round skin marks and impressions from small tentacles. Approximately 20 percent of the victims had long, more than 20 cm, linear and crossed marks with frequent systemic phenomena, such as malaise, vomiting, dyspnea, and tachycardia. The former is compatible with the common hydromedusa from Southeast and Southern Brazil (Olindias sambaquiensis). The long linear marks with intense pain and systemic phenomena are compatible with envenoming by the box jellyfish Tamoya haplonema and Chiropsalmus quadrumanus and the hydrozoan Portuguese man-of-war (Physalis physalis). There was an association between skin marks and probable accident etiology. This simple observation rule can be indicative of severity, as the Cubozoa Class (box jellyfish) and Portuguese man-of-war cause the most severe accidents. In such cases, medical attention, including intensive care, is important, as the systemic manifestations can be associated with death.

Cnidários são animais que apresentam no corpo (especialmente nos tentáculos) organelas de defesa chamadas nematocistos, podendo causar graves envenenamentos. Este trabalho procura estabelecer padrões clínicos auxiliares na identificação das espécies de cnidários brasileiros e pesquisar provável correlação das lesões na pele com a gravidade do acidente. Cento e vinte e oito pacientes foram observados no Pronto-Socorro de Ubatuba (Litoral Norte do estado de São Paulo) em período de seis anos (2002-2008). Cerca de 80 por cento dos acidentes mostraram apenas manifestações locais (dor, eritema e edema). Nestes casos, as marcas cutâneas foram pequenas, ovais e arredondadas, algumas vezes com impressões de pequenos tentáculos. As marcas foram menores que 20 cm. Aproximadamente 20 por cento das vítimas tinham lesões longas, lineares e cruzadas, maiores que 20 cm com frequente observação de fenômenos sistêmicos, como mal estar, vômitos, dispnéia e taquicardia. O padrão das marcas arredondadas e curtas é compatível com hidromedusa muito comum nas regiões Sudeste e Sul do Brasil (Olindia sambaquiensis), que causa acidentes de pequena magnitude. As marcas longas e lineares, associadas à dor intensa e fenômenos sistêmicos, são compatíveis com envenenamento pelas cubomedusas Tamoya haplonema e Chiropsalmus quadrumanus e o hidrozoário Physalis physalis, a caravela. Houve associação entre as marcas cutâneas e a provável etiologia do acidente. Esta regra simples de observação clínica pode ter valor clínico, uma vez que a Classe Cubozoa (vespas-do-mar) e as caravelas causam os acidentes mais graves. Nestes casos, a atenção médica deve ser redobrada, incluindo cuidados intensivos, uma vez que fenômenos sistêmicos podem se associar a óbitos.

Faunistic study and biodiversity of scorpions in Qeshm Island [Persian Gulf]

Scorpions are known as the most widespread poisonous creatures that cause casualties and death to human. They are distributed in tropical and subtropical areas. Among the sixteen Iranian Island in the Persian Gulf, Qeshm Island is the biggest and is located in the focus of the important internal and international commercial marinelines. Furthermore, thousands of tourists also visit the Island every year for its natural beauties and the siteseeings. The present research study was carried out during 1998-99 throughout Qeshm Island in order to know the species of scorpions, their abundance, the distribution and control strategy in order to reduce the scorpion stings and to safeguard the visitors as well as the local population. Collections were made randomly during the night. Samples were searched by black light and then collected by forceps. A total of 102 scorpions were captured. The scorpions were identified as Buthotus jayakari numbered 42 specimens [41.17%] and B. leptochelys numbering only 7 specimens [6.86%] belonging to the family Buthidae. Androctonus crassicauda was collected in the most parts of the Island and considered as the dominant species. The sex ratio was 1:1.53 in favor of females. B. leptochelys was rare species and by far restricted in its distribution. Considering the high population of A. crassicauda and its wide distribution, it is regarded to be responsible for the majority of scorpion stings in Qeshm Island

Lizard bite in Indian child : Case report.

Lizard bite is very uncommon in children. Here we report a child who had bitten by lizard on the right thumb and recovered without any complication.

Intravenous ascorbic acid as a treatment for severe jellyfish stings

We report a case of jellyfish envenomation in a 39 year old male. He was stung extensively on both lower limbs by an unidentified jellyfish. This occurred in shallow waters of a beach in the vicinity of Labuan Island, Malaysia. The patient received ambulatory treatment with parenteral and oral ascorbate with remarkable recovery

Mordedura de perro en la infancia: estudio epidemiológico y clínico de 118 casos / Dog bites in childhood: epidemiological and clinical study of 118 cases

Introducción. El objetivo del presente estudio es el describir las características epidemiológicas, clínicas y tratamiento recibido por niños con lesiones por mordedura de perro, atendidos en una Unidad de Medicina Familiar. Material y métodos. En forma prospectiva se evaluaron niños menores de 18 años de edad, que sufrieron mordedura de perro, atendidos en una unidad de atención primaria y enviados al Servicio de Medicina Preventiva; siendo evaluados conforme los lineamientos de la Norma Oficial Mexicana para la Prevención y Control de la Rabia. El estudio se realizó en un período de 12 meses, obteniéndose de cada paciente variables demográficas y epidemiológicas relacionadas con el accidente. El tipo de lesión se clasificó de acuerdo con el criterio de Guarnera. La organización y análisis de los datos se presentan utilizando los elementos de la estadística descriptiva, utilizándose la prueba X² para establecer asociación entre las variables categóricas. Resultados. Se incluyeron en el estudio un total de 118 niños, con promedio de edad de 6 años. La mayoría de los accidentes ocurrieron en el hogar (57 por ciento), la participación de perros conocidos del niño se cuantificó en 54 por ciento. Los menores de 5 años presentaron mayor riesgo de agresiones provocadas (60 por ciento) que los niños de mayor edad. Las Lesiones localizadas en la cara y cabeza fueron más frecuentes en los niños pequeños (50 por ciento). La mayoría de las lesiones no fueron graves; 13 se infectaron y casi 50 por ciento de los pacientes requirieron tratamiento antirrábico. Conclusiones. En nuestro medio las mordeduras de perro en la infancia representan un problema de salud frecuente. El tratamiento médico debe incluir un cuidado adecuado de la herida, así como evaluación de vacunación antirrábica. La prevención de las mordeduras de perro requiere de medidas dirigidas a los propietarios de perros, padres, niños y autoridades locales

Escorpionismo en Girardot Hospital San Rafael: Enero-Junio de 1994

Objetivo: Identificar las principales caracteristicas clínicas de la picadura de escorpion y el manejo médico en nuestro medio, así como el comportamiento de las variables: sexo, edad, sitio y hora de las picaduras. Materiales y metodos: Se revisaron las historias desde enero 1 hasta junio 30 de 1994, partiendo de la base de datos del Hospital San Rafael de Girardot, donde estan clasificadas las enfermedades según el codigo internacional de enfermedades. Los datos fueron tabulados y anlizados independientemente para cada variable. resultados. Se revisaron 25 historias de picadura de escorpión, la cual fue más frecuente en mujeres (56 porciento), y en horas de la noche (73 porciento). Las manos y pies se constituyeron en las zonas del cuerpo más picadas, con 30 y 35 porciento respectivamente. Su variación con los meses no tuvo importancia. Los medicamentos más utilizados fueron los antihistaminicos (88 porciento), los glucocorticoides (32 porciento) y adrenalina (32 porciento). Concluciones: La picadura de escorpion es frecuente en girardot, su tratamiento no fue el más indicado

Pig bite in Brazil: a case series from a teaching hospital

A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberl andia, in southeastern Brazil. Most cases (21) were from Uberl andia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5 per cent ) occurred between 7.00 a.m. and 7.00 p.m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 +/- SD 22.06, median 36). The bites were more common on the upper limbs, particularly on the forearms. In 11 (47.8 per cent ) cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation of the pig for slaughter. The following medical procedures were performed: local cleansing in 19(82.6 per cent ) cases, rabies vaccine (12; 52.2 per cent ), antirabies serum (2; 8.7 per cent ), suturing (6; 26.1 per cent ) and tetanus vaccine (12; 52.2 per cent ). There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberl andia can be estimated to be about 1.5/100,000