Envenomation by stonefish follows penetration of one or more spines, usually into the hand or foot.
Local findings:
(1) extreme pain, starting at the point of spine penetration, and then extending to involve the entire limb
(2) blue discoloration around the embedded spine
(3) edema of the affected limb
(4) absence of extensive tissue necrosis
(5) vesicles
(6) limb paralysis
Systemic findings may include:
(1) restlessness or delirium
(2) headache
(3) tremors
(4) maculopapular skin rash
(5) nausea and vomiting
(6) diarrhea
(7) abdominal pain
(8) pallor
(9) seizures
(10) respiratory distress with cyanosis
(11) diaphoresis
(12) hypertension or hypotension
(13) bradycardia or tachycardia
(14) syncope
(15) altered consciousness including coma
(16) neuropathy
(17) fever
(18) rarely anaphylaxis
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Specialty: Toxicology, Emergency Medicine, Critical Care
