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Stingray injury in a domestic aquarium
Author(s) -
Schiera Alberto,
Battifoglio Maria Luisa,
Scarabelli Gabriele,
Crippa Dario
Publication year - 2002
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.2002.1333_4.x
Subject(s) - medicine , stingray , lidocaine , dorsum , impaction , hydrocodone , surgery , physical examination , anatomy , oxycodone , opioid , ecology , receptor , biology
A 36‐year‐old man presented with acute blistering on the dorsal aspect of his left hand and a bullous eruption on the dorsal aspect of the fingers, which were erythematous and edematous. A small, deep laceration, partially covered by a crust, was also visible on the same hand ( Fig. 1). The patient stated that he had been stung by a freshwater stingray ( Potamotrygon reticulatus ) ( Fig. 2) while he was feeding the animal in his aquarium. Figure 1 Blistering on the dorsal aspect of the hand and bullous eruption on the dorsal aspect of the fingers. A small, deep ulceration, partially covered by a crust, is also visible2Juvenile specimen of stingray, Potamotrygon reticulatusHe complained of quite intense pain, beginning a few minutes after envenomation at the site of the injury, and progressively extending into the surrounding areas. He received intravenous fentanyl + morphine + tramadol, while the affected part was immersed in hot water (45 °C) in order to denature the heat‐labile venom and provide pain relief. The patient refused prophylactic injection of tetanus toxoid. The area was infiltrated with 1% lidocaine and examined carefully. Pieces of foreign material were removed. The wound was thoroughly irrigated and cleansed with antiseptic solution and left open. A plain radiographic study of the injured area excluded retained barbs or other foreign material. A neurologic examination revealed reduction of tactile sensitivity at the distal part of the left forearm and fingers. There were no obvious abnormal physical signs: electrocardiogram was normal, as well as blood pressure, heart rate and temperature. The patient received a prophylactic short course of oral antibiotic therapy with an advanced generation cephalosporin and a macrolide. Over the next 2 months, the wound healed slowly by second intention, the wound was allowed to heal from the edge without surgical closure. At a 5‐month follow‐up visit, the wound appeared to be completely healed, although the patient still complained of sporadic para‐anesthesia of the left hand and forearm.