Effective Pre-Clinical Treatment of Fish Envenoming with Polyclonal Antiserum.

Envenomation by venomous fish, although not always fatal, is capable of causing damage to homeostasis by activating the inflammatory process, with the formation of edema, excruciating pain, necrosis that is difficult to heal, as well as hemodynamic and cardiorespiratory changes. Despite the wide variety of pharmacological treatments used to manage acute symptoms, none are effective in controlling envenomation. Knowing the essential role of neutralizing polyclonal antibodies in the treatment of envenoming for other species, such as snakes, this work aimed to produce a polyclonal antiserum in mice and test its ability to neutralize the main toxic effects induced by the venoms of the main venomous Brazilian fish. We found that the antiserum recognizes the main toxins present in the different venoms of Thalassophryne nattereri, Scorpaena plumieri, Potamotrygon gr. Orbignyi, and Cathorops spixii and was effective in pre-incubation trials. In an independent test, the antiserum applied immediately to the topical application of T. nattereri, P. gr orbygnyi, and C. spixii venoms completely abolished the toxic effects on the microcirculation, preventing alterations such as arteriolar contraction, slowing of blood flow in postcapillary venules, venular stasis, myofibrillar hypercontraction, and increased leukocyte rolling and adherence. The edematogenic and nociceptive activities induced by these venoms were also neutralized by the immediate application of the antiserum. Importantly, the antiserum prevented the acute inflammatory response in the lungs induced by the S. plumieri venom. The success of antiserum containing neutralizing polyclonal antibodies in controlling the toxic effects induced by different venoms offers a new strategy for the treatment of fish envenomation in Brazil.

Nonfatal, Nonpredatory Jaguar Attacks in Brazil: A Case Series.

The jaguar, Panthera onca (Linnaeus, 1758), is the biggest felid in the Americas. Its range extends from the southwestern United States to northern Argentina. Herein, we present 5 nonfatal jaguar attacks that occurred in Brazil between March 2010 and November 2021. Most of the cases occurred when the victim encountered a jaguar guarding its food or cubs or devouring prey; none appeared to be the result of predatory behavior.

Repair of non-lethal vascular injury caused by giant anteater (Myrmecophaga tridactyla) in Brazil.

The giant anteater is a mammal found in Central and South America. These animals have claws that can reach 6.5 centimeters in length, which they use to dig anthills to obtain food and for defense. We report the case of a 52-year-old male patient with a history of epilepsy who was taken unconscious to the emergency room due to injuries to his right arm caused by an anteater. He underwent surgical exploration to investigate suspected vascular trauma, revealing a combined (arterial and venous) injury of the brachial vessels, which were repaired. He recovered well and was discharged on the second postoperative day. During outpatient follow-up he continued to improve, with no neurological or vascular sequelae.

Aquatic Antagonists: Sea Cucumbers (Holothuroidea).

Sea cucumbers are sausage-shaped aquatic creatures living on the ocean floors across the world. They are considered a food delicacy in many countries but also are known to have many beneficial pharmaceutical properties; however, sea cucumbers also contain a dangerous component called holothurin, which has been shown to have a negative impact on the health of both humans and other wildlife. In humans, exposure to holothurin can cause a painful irritant dermatitis, irritation of the mucous membranes, potential blindness, and, if ingested, even possible death. Treatment options include irrigation with seawater, soap, isopropyl alcohol, and vinegar.

New pandemic, old bugs: A case of cimicosis (Bed Bug) in a neglected elderly patient during the coronavirus disease quarantine.

Bed bugs are hematophagous arthropods that can parasitize humans. During the coronavirus disease pandemic, there has been an increase in elderly neglect. A man in his 90s came to the hospital complaining of generalized pruritus. Despite being a dependent patient, he was left alone in a home by his relatives during the pandemic. Examination revealed inflammatory nodules in addition to a live bed bug crawling over his trunk. Identifying a bed bug during consultation is an uncommon feature that can help determine a particular diagnosis. As this case shows, the need for social isolation during pandemics can contribute to elder abuse and neglect.

Acute bullous hemorrhagic prurigo: a diagnostic challenge.

Insect bites and bite wounds are quite common and most often have mild repercussions in humans. Statistics on the incidence of accidents caused by insects are not available, and the skin reactions after the bites are not always known. The authors present two cases of patients with hemorrhagic blisters on their hands after tabanidae bites and discuss the factors that cause the problem and the importance of the differential diagnosis of blisters with hemorrhagic content on human skin.

Skin manifestations of tick bites in humans.

Ticks are blood-sucking arthropods that attach to human skin through oral devices causing diverse initial cutaneous manifestations, and may also transmit serious infectious diseases. In certain situations, the Health Teams (and especially dermatologists) may face difficulties in identifying the lesions and associating them to the parasites. To assist them in clinical diagnosis, we suggest a classification of the skin manifestations in primary lesions, which occur by the attachment the tick to the host (for toxicity and the anticoagulant substances in the saliva and/or marked inflammation by the penetration and permanence of the mouthparts) and secondary lesions that are manifestations of infections caused by rickettsia, bacteria, protozoa and fungi inoculated by the ticks.

Injuries caused by freshwater stingrays in the Tapajós River Basin: a clinical and sociodemographic study.

INTRODUCTION: Freshwater stingray envenomations are an important cause of morbidity in riverine populations living in various regions of Brazil. The sequelae include temporary or permanent disability. This study aimed to identify sociodemographic, clinical, and therapeutic aspects related to stingray injuries in such populations. METHODS: This cross-sectional study was conducted in the Extractive Reserve of Tapajos-Arapiuns, located in the municipalities of Santarém and Aveiro (Pará State). A convenience sample comprising 300 local adults was used to obtain data by means of a questionnaire/ interview. RESULTS: Overall, 19 (6.3%) participants reported having sustained a stingray injury in the 12 months prior to the study. All 19 were injured either while fishing (n=13 [68.4%]) or engaging in other riverine activities. Most injuries [n=14 (73.7%)] occurred from September through November, and most injured respondents [n=15 (78.9%)] reported seeing stingrays at beaches. Severe pain and the appearance of ulcers in the later stages of envenomation were described by 18 (94.7%) and 12 (63.2%) participants, respectively. CONCLUSIONS: Freshwater stingray injuries, which should be considered occupational injuries, are common in the study area, especially in places like beaches or in the lakes that form during the dry season, when stingrays are routinely observed. A significant proportion of respondents was unaware of the correct first aid measures and had insufficient resources to treat the complications of these injuries in the locality where they reside. Interactive activities involving local residents - such as lectures and the distribution of simple pamphlets providing information about stingray injuries - are needed.

Human envenomations caused by Portuguese man-of-war (Physalia physalis) in urban beaches of São Luis City, Maranhão State, Northeast Coast of Brazil.

INTRODUCTION:: The clinical and epidemiological aspects associated with Portuguese man-of-war envenomation were investigated and characterized. METHODS:: Data from recorded envenomation events between 2005 and 2013 were provided by the GBMar (Group of Firemen Maritime of Maranhão State) and SEMUSC (Municipal Secretary of Security with Citizenship). RESULTS:: Most victims were children, and clinical manifestations included intense pain, edema, erythema, and rare systemic manifestations. CONCLUSIONS:: The envenomation events were predictable and based on patterns involving multiple factors (environmental and/or human behavior); however, the initially applied measures did not match the current recommendations of the Health Ministry of Brazil.

Diabetes mellitus and the skin.

Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes.

Diagnostic imaging of injuries caused by venomous and traumatogenic catfish.

Injuries caused by fish are common in marine and freshwater environments. Catfish of the Ariidae and Pimelodidae families cause about 80% of those injuries. One of the complications of injuries caused by fish is the retention of fragments of the stinger in the wounds. Here we report five cases (of a total of 127 injuries caused by catfish in the Brazilian coast) in which the retained fragments were detected by radiological examination. Retained fragments should be considered in patients stung by catfish. A simple X-ray is sufficient to detect fragments of stingers in the wounds.

Injuries caused by the venomous catfish pintado and cachara (Pseudoplatystoma genus) in fishermen of the Pantanal region in Brazil.

INTRODUCTION: the fishing activity throughout the Upper Paraguay River Basin has huge financial and biological importance. This retrospective study investigated the occurrence of injuries caused by fish of the Pseudoplatystoma genus (spotted catfish or pintado and striped catfish or cachara) in professional fishermen of the Pantanal of Mato Grosso do Sul State. METHODS: we collected information through a questionnaire, showing that fishing is carried out by workers with low level of education, mainly adults or seniors with low financial gains. RESULTS: in Miranda town, 126 of 315 fishermen were interviewed and 38 individuals reported injuries (30.16%). In Corumbá town, 355 of 627 fishermen were interviewed, and 111 (56,61%) reported injuries. The lacerated lesions were the most common, associate with edema, erythema, radiating pain to the root of the limb, paresthesias and local necrosis. More rarely, they reported the occurrence of fever, cardiac arrhythmias and cold sweating. These manifestations may be associated with late secondary infections or envenomations caused by the toxins in the stingers of the fish. Many questionable and inappropriate treatments are used, sometimes aggravating the injuries. CONCLUSIONS: the freshwater professional fishermen need guidance on first aid measures and prevention of accidents caused by these venomous fish.

First report of the characterization of the pathophysiological mechanisms caused by the freshwater catfish Pimelodus maculatus (order: Siluriformes).

Injuries caused by aquatic animals in Brazil in most cases are provoked by marine and freshwater catfish. Pimelodus maculatus is a freshwater catfish very common in Brazilian basins that causes frequent accidents mainly amongst fishermen, and whose venom characteristics and pathological mechanisms of the venom are poorly known. In the present study for the first time, we have characterized the main pathophysiological mechanisms associated with the clinical manifestation (pain, local inflammation and edema) of the envenomations caused by P. maculatus crude venom. It was estimated that the crude venom of one P. maculatus stinger contains approximately 100 µg of protein, likely the quantity involved in the envenomation. P. maculatus crude venom induced marked nociceptive and edematogenic effects and caused vascular permeability alterations at doses from 30 to 100 µg/animal. Additionally, P. maculatus crude venom caused a decrease in the contraction force in in situ frog heart, did not cause hemorrhage or alterations in clotting times (prothrombin time and activated partial thromboplastin time), but induced significant changes in the levels of CK and its isoenzyme CK-MB in mice. In the present work, we present a correlation between the effects obtained experimentally and the main symptoms observed in the human accidents provoked by P. maculatus.

Report of 15 injuries caused by lionfish (pterois volitans) in aquarists in Brazil: a critical assessment of the severity of envenomations.

Lionfish are venomous fish that belong to the Scorpaenidae family. Individuals of this family and those of the Synanceiidae family comprise most of the existing venomous fish in the world. Lionfish are originally found in the Indo-Pacific, but they have received special attention in the last years for their dissemination in the Atlantic Ocean, with the emergence of large populations in the USA, Caribbean and South America. Because of its beauty, this fish has always been present in private and commercial aquariums around the world. Herein, we describe 15 envenomations in aquarists registered in a period of eighteen years (1997-2014). The stings caused excruciating pain and marked inflammation, with local erythema, edema, heat, paleness and cyanosis. In one case, it was possible to observe vesicles and blisters. There were no skin necroses or marked systemic manifestations. We discuss the possible coming of the fish to South America and the circumstances and clinical impact of the envenomations.

Seabather's eruption: report of fourteen cases.

Seabather's eruption is a papulo-pruritic dermatitis caused by the nematocysts of the larvae of the jellyfish Linuche unguiculata retained in the clothing fibers. Previously reported in Brazil, this work describes fourteen cases that occurred in the State of Santa Catarina, in southern Brazil. The new cases observed over a short period of time (the first half of January, 2012), at the height of the summer season, should alert health teams to possible epidemics on the coast of the state of Santa Catarina.