A report of two cases

J Res Med Sci. 2012 Jun; 17(6): 578–581.

Gholamali Dorooshi

Department of Forensic Medicine and Toxicology, Isfahan University of Medical Sciences, Isfahan, Iran

Department of Forensic Medicine and Toxicology, Isfahan University of Medical Sciences, Isfahan, Iran

Address for correspondence: Mr. Gholamali Dorooshi, Isfahan University of Medical Sciences, Isfahan, Iran.
E-mail: moc.oohay@56yhsavrodg

Received 2011 Oct 19; Revised 2012 Feb 23; Accepted 2012 May 24.

Copyright : © Journal of Research in Medical Sciences

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Venomous catfish stings are a common environment hazard worldwide. Although these stings are often innocuous, significant morbidity may result from stings, including severe pain, retained foreign bodies, infection, respiratory compromise, arterial hypotension, and cardiac dysrhythmias. Treatment included hot water immersion, analgesia, wound exploration, and prophylactic antibiotics. In this article, two cases of stings by catfish referred to the poison center of Noor Hospital, Isfahan University of Medical Sciences and their treatments have been reported.

Keywords: Bites, Catfish, stings, venomous animals

INTRODUCTION

Numerous species of fish are capable of inflicting painful or even dangerous stings by means of dorsal or caudal spines provided with complex venom glands.[1] Catfish [] and stingrays have stings, not spines. The lesser weeverfish, Echiichthys vipera,[2,3] the spiny dogfish (Squalus acanthias) and some species of stingray occur around the world, and can inflict serious stings. In warmer waters, species of stingray, scorpionfish, catfish,[4] rabbitfish, stonefish,[5] the aptly named “bearded ghoul,” stargazers, and toadfish are potentially dangerous. [1] Surgeonfish (doctorfish, tang), ratfish, and horned venomous sharks have also envenomed humans.[6] Stingray spines, which are up to 30 cm long, can cause severe lacerating injuries especially to the lower legs, but if the victim inadvertently lies on the ray or falls onto it, the spine may penetrate the thoracic or abdominal cavities with fatal results.[7] In a review of 603 cases of stingray injuries, only two deaths occurred, as a result of intra-abdominal trauma.[8]

Catfish (order Siluriformes) are a diverse group of ray-finned fish. Named for their prominent barbells, which resemble a cat’s whiskers, catfish range in size and behavior from the heaviest and longest, the Mekong giant catfish from Southeast Asia and the second longest, the wels catfish of Eurasia, to detritivores (species that eat dead material on the bottom), and even to a tiny parasitic species commonly called the candiru, Vandellia cirrhosa. Many of the smaller species, particularly the freshwater genus Corydoras, are important in the aquarium hobby. [9] The stinging catfish Heteropneustes fossilis (Bloch, 1794) has become a popular aquarium fish and is available in almost every pet shop.[10]

A great number of species of marine catfish, including Plotosus lineatus (the oriental catfish) and Galeichthys felis (the common sea catfish) and several species of freshwater catfish are capable to cause human envenomation. Venom is delivered through a single dorsal spine and two pectoral spines. Clinically, a catfish sting is comparable to that of a stingray.[6] The marine catfish envenomations are generally more severe than those of their freshwater counterparts.[6]

Venomous catfish have a sharp and stout sting immediately in front of the soft-rayed portion of dorsal and pectoral fins. Stings are derived from fin rays and are covered by a thin integumentary sheath. There is no external sign of the venom glands, which are located in a series of sharp recurring teeth capable of cutting into a victim’s flesh, helping the venom to be absorbed and often seeding serious infections. The stings of the catfish are very dangerous once they have been erected.[11] In catfish, the pectoral fins aid the fish in its defense mechanism against predators.[12] The ability of catfish to inflict extremely painful wounds with their pectoral and dorsal stings has been well known for many decades. Catfish sting envenomation is a frequent cause of morbidity among anglers, fishermen, food processors, and aquarists.[13,14,15] Due to the long distance from the sea and the lack of catfish in Isfahan province’s rivers and ponds investigate bites and stings by venomous animals that are kept in the aquarium is very important.

CASE REPORT

Two cases of stings by freshwater catfish have been referred in the years 2009 and 2011 to the referral poisoning center of Noor and Ali Asghar Hospital, Isfahan University of Medical Sciences.

Stings occurred by immersion of hand into the catfish aquarium. The first case was a 42-year-old man with a wound on the back of right hand and the second was a 35-year-old man had a wound on the palmar area of base of left third finger []. Patients immediately had been entered to the emergency poisoning center by their relatives. On admission time they were awake, alert with stable vital signs, complaining severe pain. On examination the patients showed laceration, bleeding, oedema, and erythema in the area of bites. No systemic symptoms and signs had developed. Neurovascular examinations of the hands were normal. The affected limbs were immersed in hot water (temperature below 50 °C). This led to a gradual reduction and elimination of pain in less than half an hour. To prevent secondary infection systemic antibiotics infusion of cefazolin 1 gm intravenous every 6 h and tetanus toxoid 250 IU intramuscular were administered. To check the possible presence of remnants of fish bite in limb, plain radiographs were taken which were normal. The wounds were irrigated with warm sterile water and 1% povidone-iodine in solution. Wounds left open to heal by secondary intention. Both the patients observed for incidence of systemic symptoms for 24 h and discharged from hospital with order of oral antibiotics. At follow-up, the wounds healed slowly by second intention and they had regained all of them baseline level of hand functions. No residual deficits in motor or sensory functions were observed.

Sting on left palmar area of third finger of our patient

DISCUSSION

Catfish have two toxicity mechanisms: the first is linked to sting penetration and rupture of the venom glandular tissue surrounding the sting, whereas the second, called crinotoxicity, is associated with the production of toxins in the entire fish skin.[12] The venom of catfish is a complex composition of hemolytic, dermonecrotic, oedema-producing, and vasospastic factors and contains several amino acids, 5HT, 5-nucleotidase, and phosphodiesterase.-[6] whose potency is largely inversely proportional to the fish size and is a defensive mechanism.[12]

As in the present study after catfish envenomation, the following symptoms and signs occurred: cutaneous oedema, erythema, and local pain. Paresthesias, localized sweating, and muscular fibrillation and weakness can be accompanied by cyanosis and inflammation around the puncture site which was not observed in our cases. Lymphangitis, cellulitis, and septicemia may be sequels in catfish envenomation.[11–15] Other systemic symptoms may also be present, including tachycardia, hypotension, nausea, and vomiting, dizziness, respiratory distress, and loss of consciousness.[11–15] Other complications include, severe tissue necrosis, necrotizing fasciitis, fatal heart perforation, radial artery injury, ulnar nerve deficit, and chronic tenosynovitis of hand.[16–21] In our patients, no systemic symptoms or other complications were seen. Death has been reported, but symptoms are usually limited to the involved extremity and respond within hours to supportive therapy.[22] The stings of all marine vertebrates are treated in a similar way. For severe stonefish and scorpion fish envenomations, antivenom is available but is usually unnecessary with milder stings.[23]

As in the present study, the affected part was immersed immediately in nonscalding hot water (45 °C/113 °F) for 30-90 min. It may also inactivate some venom in the wound. [6] Recurrent pain may respond to repeated hot-water treatment. Cryotherapy is contraindicated.[24] The use of parenteral analgesics may be necessary to control pain. Opiate analgesics may be required. Injection of a local anesthetics is less effective even when applied as a ring block in the case of stung digits, but a local nerve block with 1% lidocaine, 0.5% bupivacaine, and sodium bicarbonate mixed in a 5:5:1 ratio does seem to work.[6,7] After soaking and anesthetic administration, the wound must be explored and debrided.[6] Radiograph or ultrasound (in particular, MRI) may localize embedded material, since catfish barbs are often radiopaque. The venomous spine (which may be barbed), fragments of membrane, and other foreign material should be removed as soon as possible.-[7] After exploration and debridement, the wound should be vigorously irrigated with warm sterile water, saline, or 1% povidone-iodine in solution. Bleeding can usually be controlled by sustained local pressure for 10-15 min. In general, wounds should be left open to heal by secondary intention or treated by delayed primary closure.[6] Systemic effects must be treated symptomatically. An adequate airway should be established and cardiopulmonary resuscitation may be needed. Severe hypotension may respond to adrenaline (epinephrine), bradycardia to atropine.[7] Tetanus prophylaxis should be given when indicated. Antibiotic management depends on several factors: the age and immune status of the victim, the interval between the injury and the presentation, and the presence of a foreign body.[11] As injuries inflicted by catfish may result in delayed presentation of infection, it was suggested that the patients should be admitted for observation.[14,25] In the case of injury inflicted by catfish, infection may develop even within three months of the incident; the patients were, therefore, instructed to have checkups.[14,25] The microbiology of infections that accompany fish-inflicted wounds usually reflects the bacterial flora of the mouth in the case of a bite, and that of the body surface in the case of sting; however, microorganisms living in the water and the skin of the affected persons may also be found. [6,26] Antibiotic treatment should be considered for serious wounds and for envenomation in immunocompromised hosts. The initial antibiotics should cover Staphylococcus and Streptococcus spp.[6] If the victim is immunocompromised, if a wound is primarily repaired and is more than minor, or if an infection develops, antibiotic coverage should be broadened to include Vibrio spp.[6]

Bacteremia resulting from wound infection with eromonas or Vibrio is more likely in patients with diabetes, cirrhosis, or the immunocompromised. Ciprofloxacin covers Vibrio and Aeromonas spp.[7] Aeromonas is common in freshwater environments.[27] As in the present study in zeman study, three patients with embedded freshwater catfish spines completed course of cephalosporins recovered without infection.[28] It is often very difficult to differentiate the symptoms of infection from those of venom-induced reactions.

Inpatient therapy may be required in patients with deep wounds, long delays in wound care, wounds with retained foreign material, wounds with spine penetration of sterile body cavities, and wounds with persistent inflammatory changes. [6]

Footnotes

Source of Support: Nil

Conflict of Interest: None declared.

REFERENCES

1. Cook GC, Zumla AI. Philadelphia, PA: Saunders/Elsevier; 2009. Manson’s Tropical Diseases; pp. 38–59. [Google Scholar]2. Davies RS, Evans RJ. Weever fish stings: a report of two cases presenting to an accident and emergency department. J Accid Emerg Med. 1996;13:139–41. [PMC free article] [PubMed] [Google Scholar]6. Auerbach PS, Norris RL. Harrison’s principles of internal medicine. In: Fauci AS, Longo DL, Kasper DL, Braunwald E, Hauser SL, Jameson JL, editors. Disorders Caused by Reptile Bites and Marine Animal Exposures. 17th ed. Vol. 391. New York: McGraw-Hill Companies; 2008. pp. 2741–54. [Google Scholar]7. Warrell DA, Cox TM, Firth JD, Edward J, Benz EJ., Jr . 4th ed. Oxford: Cambridge: Oxford Press; 2003. Oxford Textbook of Medicine; p. 935. [Google Scholar]8. Hoffman RS, Nelson LS, Howland MA, Lewin NA, Flomenbaum NE, Goldfrank LR. 8th ed. New York: McGraw-Hill Companies; 2006. Goldfranks Toxicologic Emergencies; pp. 1637–9. [Google Scholar]10. Satora L, Anand JS, Korolkiewicz R, Burda P, Gawlikowski T. Stinging catfish spine envenamation. Przegl Lek. 2009;66:282–4. [PubMed] [Google Scholar]11. Satora L, Kuciel M, Gawlikowski T. Catfish Stings and the Venom Apparatus Of The African Catfish. Ann Agric Environ Med. 2008;15:163–6. [PubMed] [Google Scholar]12. Haddad V, Jr, Martins IA. Frequency and gravity of human Envenomations caused by marine catfish (suborder Siluroidei): A clinical and epidemiological study. Toxicon. 2006;47:838–43. [PubMed] [Google Scholar]13. De Haro L, Pommier P. Envenomation: A real risk keeping exotic house pets. Vet Hum Toxicol. 2003;45:214–16. [PubMed] [Google Scholar]14. Satora L, Pach D, Targosz D, Szkolnicka B. Stinging Catfish Poisoning. Clin Toxicol (Phila) 2005;43:893–4. [PubMed] [Google Scholar]15. Sein Anand J, Chodorowski Z, Waldman W. Hand wound after an active sting with a toxin spine of a Catfish (Heteropneustes fossilis) – a case report. Przegl Lek. 2005;62:526. [PubMed] [Google Scholar]16. Mann JW, 3rd, Werntz JR. Catfish stings to the hand. J Hand Surg Am. 1991;16:318–21. [PubMed] [Google Scholar]17. Carty MJ, Kutz RH, Finley RL, Jr, Upton J, Rogers GF. Digital catfish envenomation mimicking necrotizing fasciitis. Plast Reconstr Surg. 2010;126:226–230. [PubMed] [Google Scholar]18. Haddad V, de Souza RA, Auerbach PS. Marine catfish sting causing fatal heart perforation in a fisherman. Wilderness Environ Med. 2008;19:114–8. [PubMed] [Google Scholar]19. Ferlic RJ, Bonatz E, Robbin ML. Radial artery injury from a catfish sting. Am J Orthop (Belle Mead NJ) 2003;32:412–4. [PubMed] [Google Scholar]20. Hess JR, Rocque BG, Mackinnon SE, Hunter DA. Ulnar nerve deficit after catfish sting. South Med J. 2005;98:750–1. [PubMed] [Google Scholar]21. Ajmal N, Nanney LB, Wolfort SF. Catfish spine envenomation: a case of delayed presentation. Wilderness Environ Med. 2003;14:101–5. [PubMed] [Google Scholar]22. Schonwald S. Philadelphia: Lippincott Williams and Wilkins; 2001. Medical Toxicology A Synopsis and Study Guide. [Google Scholar]24. Pacy H. Catfish and stingrays: hot water is first aid. Aust Fam Physician. 1998;27:343–4. [PubMed] [Google Scholar]25. Blomkalns AL, Otten EJ. Catfish spine envenomation: a case report and literature review. Wilderness Environ Med. 1999;10:242–6. [PubMed] [Google Scholar]26. Satora L. Bites by the Grass Snake Natrix natrix. Vet Hum Toxicol. 2004;46:334. [PubMed] [Google Scholar]27. Ikpi G, Offem B. Bacterial infection of mudfish Clarias gariepinus (Siluriformes: Clariidae) fingerlings in tropical nursery ponds. Rev Biol Trop. 2011;59:751–9. [PubMed] [Google Scholar]28. Zeman MG. Catfish stings: A report of three cases. Ann Emerg Med. 1989;18:211–3. [PubMed] [Google Scholar]

A report of two cases

J Res Med Sci. 2012 Jun; 17(6): 578–581.

Gholamali Dorooshi

Department of Forensic Medicine and Toxicology, Isfahan University of Medical Sciences, Isfahan, Iran

Department of Forensic Medicine and Toxicology, Isfahan University of Medical Sciences, Isfahan, Iran

Address for correspondence: Mr. Gholamali Dorooshi, Isfahan University of Medical Sciences, Isfahan, Iran.
E-mail: moc.oohay@56yhsavrodg

Received 2011 Oct 19; Revised 2012 Feb 23; Accepted 2012 May 24.

Copyright : © Journal of Research in Medical Sciences

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Venomous catfish stings are a common environment hazard worldwide. Although these stings are often innocuous, significant morbidity may result from stings, including severe pain, retained foreign bodies, infection, respiratory compromise, arterial hypotension, and cardiac dysrhythmias. Treatment included hot water immersion, analgesia, wound exploration, and prophylactic antibiotics. In this article, two cases of stings by catfish referred to the poison center of Noor Hospital, Isfahan University of Medical Sciences and their treatments have been reported.

Keywords: Bites, Catfish, stings, venomous animals

INTRODUCTION

Numerous species of fish are capable of inflicting painful or even dangerous stings by means of dorsal or caudal spines provided with complex venom glands.[1] Catfish [] and stingrays have stings, not spines. The lesser weeverfish, Echiichthys vipera,[2,3] the spiny dogfish (Squalus acanthias) and some species of stingray occur around the world, and can inflict serious stings. In warmer waters, species of stingray, scorpionfish, catfish,[4] rabbitfish, stonefish,[5] the aptly named “bearded ghoul,” stargazers, and toadfish are potentially dangerous.[1] Surgeonfish (doctorfish, tang), ratfish, and horned venomous sharks have also envenomed humans.[6] Stingray spines, which are up to 30 cm long, can cause severe lacerating injuries especially to the lower legs, but if the victim inadvertently lies on the ray or falls onto it, the spine may penetrate the thoracic or abdominal cavities with fatal results. [7] In a review of 603 cases of stingray injuries, only two deaths occurred, as a result of intra-abdominal trauma.[8]

Catfish (order Siluriformes) are a diverse group of ray-finned fish. Named for their prominent barbells, which resemble a cat’s whiskers, catfish range in size and behavior from the heaviest and longest, the Mekong giant catfish from Southeast Asia and the second longest, the wels catfish of Eurasia, to detritivores (species that eat dead material on the bottom), and even to a tiny parasitic species commonly called the candiru, Vandellia cirrhosa. Many of the smaller species, particularly the freshwater genus Corydoras, are important in the aquarium hobby.[9] The stinging catfish Heteropneustes fossilis (Bloch, 1794) has become a popular aquarium fish and is available in almost every pet shop.[10]

A great number of species of marine catfish, including Plotosus lineatus (the oriental catfish) and Galeichthys felis (the common sea catfish) and several species of freshwater catfish are capable to cause human envenomation. Venom is delivered through a single dorsal spine and two pectoral spines. Clinically, a catfish sting is comparable to that of a stingray.[6] The marine catfish envenomations are generally more severe than those of their freshwater counterparts.[6]

Venomous catfish have a sharp and stout sting immediately in front of the soft-rayed portion of dorsal and pectoral fins. Stings are derived from fin rays and are covered by a thin integumentary sheath. There is no external sign of the venom glands, which are located in a series of sharp recurring teeth capable of cutting into a victim’s flesh, helping the venom to be absorbed and often seeding serious infections. The stings of the catfish are very dangerous once they have been erected.[11] In catfish, the pectoral fins aid the fish in its defense mechanism against predators.[12] The ability of catfish to inflict extremely painful wounds with their pectoral and dorsal stings has been well known for many decades. Catfish sting envenomation is a frequent cause of morbidity among anglers, fishermen, food processors, and aquarists. [13,14,15] Due to the long distance from the sea and the lack of catfish in Isfahan province’s rivers and ponds investigate bites and stings by venomous animals that are kept in the aquarium is very important.

CASE REPORT

Two cases of stings by freshwater catfish have been referred in the years 2009 and 2011 to the referral poisoning center of Noor and Ali Asghar Hospital, Isfahan University of Medical Sciences.

Stings occurred by immersion of hand into the catfish aquarium. The first case was a 42-year-old man with a wound on the back of right hand and the second was a 35-year-old man had a wound on the palmar area of base of left third finger []. Patients immediately had been entered to the emergency poisoning center by their relatives. On admission time they were awake, alert with stable vital signs, complaining severe pain. On examination the patients showed laceration, bleeding, oedema, and erythema in the area of bites. No systemic symptoms and signs had developed. Neurovascular examinations of the hands were normal. The affected limbs were immersed in hot water (temperature below 50 °C). This led to a gradual reduction and elimination of pain in less than half an hour. To prevent secondary infection systemic antibiotics infusion of cefazolin 1 gm intravenous every 6 h and tetanus toxoid 250 IU intramuscular were administered. To check the possible presence of remnants of fish bite in limb, plain radiographs were taken which were normal. The wounds were irrigated with warm sterile water and 1% povidone-iodine in solution. Wounds left open to heal by secondary intention. Both the patients observed for incidence of systemic symptoms for 24 h and discharged from hospital with order of oral antibiotics. At follow-up, the wounds healed slowly by second intention and they had regained all of them baseline level of hand functions. No residual deficits in motor or sensory functions were observed.

Sting on left palmar area of third finger of our patient

DISCUSSION

Catfish have two toxicity mechanisms: the first is linked to sting penetration and rupture of the venom glandular tissue surrounding the sting, whereas the second, called crinotoxicity, is associated with the production of toxins in the entire fish skin.[12] The venom of catfish is a complex composition of hemolytic, dermonecrotic, oedema-producing, and vasospastic factors and contains several amino acids, 5HT, 5-nucleotidase, and phosphodiesterase.-[6] whose potency is largely inversely proportional to the fish size and is a defensive mechanism.[12]

As in the present study after catfish envenomation, the following symptoms and signs occurred: cutaneous oedema, erythema, and local pain. Paresthesias, localized sweating, and muscular fibrillation and weakness can be accompanied by cyanosis and inflammation around the puncture site which was not observed in our cases. Lymphangitis, cellulitis, and septicemia may be sequels in catfish envenomation.[11–15] Other systemic symptoms may also be present, including tachycardia, hypotension, nausea, and vomiting, dizziness, respiratory distress, and loss of consciousness.[11–15] Other complications include, severe tissue necrosis, necrotizing fasciitis, fatal heart perforation, radial artery injury, ulnar nerve deficit, and chronic tenosynovitis of hand.[16–21] In our patients, no systemic symptoms or other complications were seen. Death has been reported, but symptoms are usually limited to the involved extremity and respond within hours to supportive therapy.[22] The stings of all marine vertebrates are treated in a similar way. For severe stonefish and scorpion fish envenomations, antivenom is available but is usually unnecessary with milder stings.[23]

As in the present study, the affected part was immersed immediately in nonscalding hot water (45 °C/113 °F) for 30-90 min. It may also inactivate some venom in the wound.[6] Recurrent pain may respond to repeated hot-water treatment. Cryotherapy is contraindicated.[24] The use of parenteral analgesics may be necessary to control pain. Opiate analgesics may be required. Injection of a local anesthetics is less effective even when applied as a ring block in the case of stung digits, but a local nerve block with 1% lidocaine, 0.5% bupivacaine, and sodium bicarbonate mixed in a 5:5:1 ratio does seem to work.[6,7] After soaking and anesthetic administration, the wound must be explored and debrided.[6] Radiograph or ultrasound (in particular, MRI) may localize embedded material, since catfish barbs are often radiopaque. The venomous spine (which may be barbed), fragments of membrane, and other foreign material should be removed as soon as possible.-[7] After exploration and debridement, the wound should be vigorously irrigated with warm sterile water, saline, or 1% povidone-iodine in solution. Bleeding can usually be controlled by sustained local pressure for 10-15 min. In general, wounds should be left open to heal by secondary intention or treated by delayed primary closure.[6] Systemic effects must be treated symptomatically. An adequate airway should be established and cardiopulmonary resuscitation may be needed. Severe hypotension may respond to adrenaline (epinephrine), bradycardia to atropine.[7] Tetanus prophylaxis should be given when indicated. Antibiotic management depends on several factors: the age and immune status of the victim, the interval between the injury and the presentation, and the presence of a foreign body.[11] As injuries inflicted by catfish may result in delayed presentation of infection, it was suggested that the patients should be admitted for observation.[14,25] In the case of injury inflicted by catfish, infection may develop even within three months of the incident; the patients were, therefore, instructed to have checkups.[14,25] The microbiology of infections that accompany fish-inflicted wounds usually reflects the bacterial flora of the mouth in the case of a bite, and that of the body surface in the case of sting; however, microorganisms living in the water and the skin of the affected persons may also be found.[6,26] Antibiotic treatment should be considered for serious wounds and for envenomation in immunocompromised hosts. The initial antibiotics should cover Staphylococcus and Streptococcus spp.[6] If the victim is immunocompromised, if a wound is primarily repaired and is more than minor, or if an infection develops, antibiotic coverage should be broadened to include Vibrio spp.[6]

Bacteremia resulting from wound infection with eromonas or Vibrio is more likely in patients with diabetes, cirrhosis, or the immunocompromised. Ciprofloxacin covers Vibrio and Aeromonas spp.[7] Aeromonas is common in freshwater environments.[27] As in the present study in zeman study, three patients with embedded freshwater catfish spines completed course of cephalosporins recovered without infection.[28] It is often very difficult to differentiate the symptoms of infection from those of venom-induced reactions.

Inpatient therapy may be required in patients with deep wounds, long delays in wound care, wounds with retained foreign material, wounds with spine penetration of sterile body cavities, and wounds with persistent inflammatory changes.[6]

Footnotes

Source of Support: Nil

Conflict of Interest: None declared.

REFERENCES

1. Cook GC, Zumla AI. Philadelphia, PA: Saunders/Elsevier; 2009. Manson’s Tropical Diseases; pp. 38–59. [Google Scholar]2. Davies RS, Evans RJ. Weever fish stings: a report of two cases presenting to an accident and emergency department. J Accid Emerg Med. 1996;13:139–41. [PMC free article] [PubMed] [Google Scholar]6. Auerbach PS, Norris RL. Harrison’s principles of internal medicine. In: Fauci AS, Longo DL, Kasper DL, Braunwald E, Hauser SL, Jameson JL, editors. Disorders Caused by Reptile Bites and Marine Animal Exposures. 17th ed. Vol. 391. New York: McGraw-Hill Companies; 2008. pp. 2741–54. [Google Scholar]7. Warrell DA, Cox TM, Firth JD, Edward J, Benz EJ., Jr . 4th ed. Oxford: Cambridge: Oxford Press; 2003. Oxford Textbook of Medicine; p. 935. [Google Scholar]8. Hoffman RS, Nelson LS, Howland MA, Lewin NA, Flomenbaum NE, Goldfrank LR. 8th ed. New York: McGraw-Hill Companies; 2006. Goldfranks Toxicologic Emergencies; pp. 1637–9. [Google Scholar]10. Satora L, Anand JS, Korolkiewicz R, Burda P, Gawlikowski T. Stinging catfish spine envenamation. Przegl Lek. 2009;66:282–4. [PubMed] [Google Scholar]11. Satora L, Kuciel M, Gawlikowski T. Catfish Stings and the Venom Apparatus Of The African Catfish. Ann Agric Environ Med. 2008;15:163–6. [PubMed] [Google Scholar]12. Haddad V, Jr, Martins IA. Frequency and gravity of human Envenomations caused by marine catfish (suborder Siluroidei): A clinical and epidemiological study. Toxicon. 2006;47:838–43. [PubMed] [Google Scholar]13. De Haro L, Pommier P. Envenomation: A real risk keeping exotic house pets. Vet Hum Toxicol. 2003;45:214–16. [PubMed] [Google Scholar]14. Satora L, Pach D, Targosz D, Szkolnicka B. Stinging Catfish Poisoning. Clin Toxicol (Phila) 2005;43:893–4. [PubMed] [Google Scholar]15. Sein Anand J, Chodorowski Z, Waldman W. Hand wound after an active sting with a toxin spine of a Catfish (Heteropneustes fossilis) – a case report. Przegl Lek. 2005;62:526. [PubMed] [Google Scholar]16. Mann JW, 3rd, Werntz JR. Catfish stings to the hand. J Hand Surg Am. 1991;16:318–21. [PubMed] [Google Scholar]17. Carty MJ, Kutz RH, Finley RL, Jr, Upton J, Rogers GF. Digital catfish envenomation mimicking necrotizing fasciitis. Plast Reconstr Surg. 2010;126:226–230. [PubMed] [Google Scholar]18. Haddad V, de Souza RA, Auerbach PS. Marine catfish sting causing fatal heart perforation in a fisherman. Wilderness Environ Med. 2008;19:114–8. [PubMed] [Google Scholar]19. Ferlic RJ, Bonatz E, Robbin ML. Radial artery injury from a catfish sting. Am J Orthop (Belle Mead NJ) 2003;32:412–4. [PubMed] [Google Scholar]20. Hess JR, Rocque BG, Mackinnon SE, Hunter DA. Ulnar nerve deficit after catfish sting. South Med J. 2005;98:750–1. [PubMed] [Google Scholar]21. Ajmal N, Nanney LB, Wolfort SF. Catfish spine envenomation: a case of delayed presentation. Wilderness Environ Med. 2003;14:101–5. [PubMed] [Google Scholar]22. Schonwald S. Philadelphia: Lippincott Williams and Wilkins; 2001. Medical Toxicology A Synopsis and Study Guide. [Google Scholar]24. Pacy H. Catfish and stingrays: hot water is first aid. Aust Fam Physician. 1998;27:343–4. [PubMed] [Google Scholar]25. Blomkalns AL, Otten EJ. Catfish spine envenomation: a case report and literature review. Wilderness Environ Med. 1999;10:242–6. [PubMed] [Google Scholar]26. Satora L. Bites by the Grass Snake Natrix natrix. Vet Hum Toxicol. 2004;46:334. [PubMed] [Google Scholar]27. Ikpi G, Offem B. Bacterial infection of mudfish Clarias gariepinus (Siluriformes: Clariidae) fingerlings in tropical nursery ponds. Rev Biol Trop. 2011;59:751–9. [PubMed] [Google Scholar]28. Zeman MG. Catfish stings: A report of three cases. Ann Emerg Med. 1989;18:211–3. [PubMed] [Google Scholar]

Catfish spine envenomation and bacterial abscess with Proteus and Morganella: a case report | Journal of Medical Case Reports

Over 1000 species of freshwater and saltwater catfish exist worldwide, with some weighing a few grams and others up to 200kg. They vary greatly in their adaptations to different ecological conditions. An Egyptian catfish, Malapterurus, contains electrical organs capable of causing a fatal electric shock in humans [1]. Candiru (genus Vandellia) is a small Amazonian catfish that is attracted to urine and may penetrate the urethral orifice of mammals, including humans, requiring surgical intervention [2]. Almost all catfish have the ability to inflict extremely painful wounds with their pectoral and dorsal spines (Figure 2). The freshwater catfish I. punctatus is capable of causing significant injury with its stings [1]. Contrary to popular belief, the prominent barbels (whiskers) characteristic of catfish are for sensory purposes only and are incapable of causing envenomation.

Figure 2

Photographs of channel catfish, Ictalurus punctatus , with exposed pectoral (A) and dorsal spines (B). Note the sharp and deeply serrated contours of the spines.

Envenomations generally occur when the catfish are being handled. They react to being grasped by lashing from side to side and locking their dorsal and pectoral spines, which are enclosed in an integumentary sheath containing venom glands, into a rigid and extended position (Figure 3).

Figure 3

Dorsal spine of the striped eel catfish, Plotosus lineatus[1]. Permission for use obtained from Darwin Press, Inc.

These sharp spines may penetrate skin, in the process damaging the delicate integumental sheath and exposing the venom glands. The retrorse barb (upturned tip) that Ictaluridae possess on their spines is capable of lacerating skin, facilitating absorption of the venom and often necessitating surgical removal [1]. Catfish venom consists of hemolytic, dermonecrotic, edema-producing, and vasospastic factors, all of which have shown to be heat, pH, and lyophilization labile [3]. A second source of toxins, crinotoxins, is released by the epidermal cells of catfish skin upon agitation. These proteinaceous substances may coat the spine and become passively introduced into the wound upon skin breach [4]. Both venom and crinotoxin promote a marked localized inflammatory reaction, resulting in common findings of local erythema, throbbing pain, hemorrhage, edema, cyanosis, and lymphangitis [5]. Systemic manifestations are rare, and the majority of cases resolve without long-term sequelae [6]. However, disabling sequelae including amputation of the affected body part due to severe tissue necrosis and death have been reported [7].

Although an infrequent occurrence, the most serious long-term complications of catfish envenomations involve infections. Ictaluridae are freshwater catfish that generally inhabit stagnant and dirty waters, potentially increasing the risk of infection. The vasoconstrictive effects of catfish toxins may also add to the infection risk by decreasing blood flow to the affected tissue [8]. A variety of organisms have been reported to be responsible for causing secondary infection, including Klebsiella, Erysipelothrix, Nocardia, Chromobacterium, Sporothrix, Actinomyces, Pseudomonas, Staphylococcus, Morganella, Edwardsiella[7], Mycobacterium[9], Aeromonas, and Vibrio species [7]. Aeromonas and Vibrio species have been reported to be the most aggressive organisms for freshwater and saltwater infections, respectively, especially in immunocompromised patients [6, 7].

The genera Proteus and Morganella are motile, facultative anaerobic Gram-negative rods with peritrichous flagella, and are assigned to the Enterobacteriaceae family mainly on the basis of shared biochemical characteristics, including the ability to oxidatively deaminate phenylalanine and, in most cases, to hydrolyze urea. In human disease, most infections are associated with prolonged hospitalization and, specifically, from colonization of indwelling catheters and associated urinary tract infections [10].

Although Sarter and colleagues isolated Proteus vulgaris from a catfish farm in the Mekong Delta, Vietnam [11], the present case report is the first, to the best of our knowledge, to describe catfish envenomation resulting in secondary infection by Proteus vulgaris. Junqueira performed a microbiological evaluation of the catfish to determine the array of organisms directly isolated from the fish [12]. Of interest, neither Gram-positive bacteria nor fungi were detected in these samples, which included 13 different Enterobacteriaceae, the least frequent of which was Proteus species. In addition, whereas the aforementioned study isolated various bacterial species directly from catfish, our study demonstrates patient isolates in the setting of a clinical infection. A MEDLINE search over the past 30 years identified only two other case reports of M. morganii infection following catfish envenomation [13].

Effects from catfish toxins, such as pain, erythema, and edema, are difficult to differentiate from a local bacterial process. However, we suspect that our patient was infected with P. vulgaris and M. morganii secondary to catfish sting. The suspicion arose because in addition to the positive wound cultures for these organisms, the patient’s condition worsened after outpatient therapy with amoxicillin-clavulanate, to which M. morganii was resistant, and improved only after having received broad spectrum Gram-negative coverage with tobramycin and ciprofloxacin, which are antibiotics that target both bacteria. The persistence of local symptomatology for days into the hospital course further supports the interpretation that a bacterial infection was present because toxin-mediated symptoms are usually short-lived, whereas bacterial infections generally persist. Sources of these bacterial strains include both the catfish and its aquatic environment, as numerous bacterial species have been isolated from the water and sediment in which catfish inhabit [14].

Initial treatment of catfish envenomation should include aggressive cleaning of the wound and the surrounding area, with an attempt to remove any remnants of spinal sheath, as this radiolucent organic matter may promote inflammation and harbor virulent waterborne organisms. Plain radiographs should be done to evaluate for foreign material and gas in the wound. Initial treatment also includes prompt administration of tetanus prophylaxis and empiric antibiotics to cover Aeromonas and Vibrio strains in freshwater and saltwater accidents, respectively. The antibiotics of choice for empiric treatment of Aeromonas are fluoroquinolones, including ciprofloxacin and levofloxacin, due to their broad Gram-negative effects [15]. Of note, Aeromonas is often resistant to penicillins and cephalosporins. A recommended antibiotic regimen for empiric coverage of Vibrio species involves doxycycline with the addition of either ceftazidime or a fluoroquinolone. Antibiotics should be adjusted based on organisms isolated and susceptibility results. After initial management, the wound should be thoroughly cleansed, irrigated, explored, and debrided if necessary, after which the lesion should be left open. The affected extremity should then be splinted and the patient closely monitored. In our patient, the presence of healthy appearing deep tissues coupled with a progressive improvement of signs and symptoms led us to pursue a conservative approach.

Live catfish should be handled carefully with gloves to avoid accidental encounters with spines. One way to handle a live catfish out of water is to grasp it behind the pectoral fins, keeping the dorsal spine pressed down with the palm of the hand [7]. Another suggested method involves gently grasping the fish in an anterior-to-posterior direction so that the erect dorsal spine fits safely between the second and third digits [6].

Report of Two Cases and Review of the Literature on JSTOR

Abstract

Two cases of serious infection following catfish spine-related injuries are presented, and the literature on this topic is reviewed. The organisms usually involved in such infections are Vibrio species, Aeromonas hydrophila, Enterobacteriaceae, Pseudomonas species, and components of the flora of the human skin. Irrigation, exploration, and culture of these wounds as well as immunization of the patient against tetanus are recommended. Patients with hepatic disease or chronic illness and immunocompromised individuals are at unusually high risk of fulminant infection due to Vibrio and Aeromonas species and should be treated with antibiotics after sustaining a water-associated wound. Patients with normal host defense mechanisms but with late wound care, punctures involving a bone or a joint, progressive inflammation hours after envenomation, fever, or signs of sepsis are at high risk for secondary infection and should receive definitive wound care and antibiotics. For moderate to severe infections, one of the following combinations constitutes a reasonable empirical regimen: (1) a tetracycline and a broad-spectrum, β-lactamase-stable β-lactam antibiotic, or (2) a tetracycline, a β-lactamase-stable penicillin, and an aminoglycoside.

Journal Information

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clinical investigation, medical microbiology, diagnosis, immune mechanisms, and treatment
of diseases caused by infectious agents. Special sections include articles on antimicrobial
resistance, bioterrorism, emerging infections, food safety, hospital epidemiology, and
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editorials, commentaries, and supplements. Published for the Infectious Diseases Society
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Marine Envenomations | Anesthesia Key

CHAPTER 145

Marine Envenomations

Presentation

After swimming in the ocean and coming into contact with marine life, the patient may seek medical attention because of local pain, swelling, or skin discoloration. Marine animal envenomations can be divided into two major categories: puncture wounds and focal rashes. Severe envenomations can be accompanied by systemic symptoms, such as vomiting, paralysis, seizures, respiratory distress, and hypotension. This review is limited to the more common injuries with minor local reactions.

Puncture Wounds

A laceration or puncture wound of the leg with blue edges suggests a stingray attack. There is immediate local intense pain, edema of soft tissue, and a variable amount of bleeding. The pain is excruciating and seems out of proportion to what might be expected based on the wound appearance alone. The pain usually peaks after 60 to 90 minutes, may radiate centrally, generally resolves over several hours, and may last as long as 48 hours. Retained fragments of the stingray’s barb may be present in the wound.

A single small ischemic (e.g., pallor and cyanosis) puncture wound with a red halo and rapid swelling suggests a lionfish or scorpion fish envenomation. The pain is immediate, intense, and radiating. Untreated, the pain peaks 60 to 90 minutes after the sting, persists for at least 6 to 12 hours, and sometimes lasts for days. The severity of envenomations seems to be mild for lionfish, more severe for scorpion fish, and most severe or even life-threatening for stonefish, which is another member of the Scorpaenidae.

The dorsal or pectoral fin spines of the catfish can often inflict an envenomation when puncturing the skin. Symptoms include intense pain, paresthesias, and numbness that may last 30 minutes to 48 hours. Erythema, hemorrhage, edema, cyanosis, and lymphangitis also are common localized findings. Catfish have retroussé barbs (tip turned up) and can produce significant damage and be difficult to remove (Figure 145-1).

Figure 145-1 Catfish spine impalement.

Multiple small punctures in an erratic pattern, with or without purple discoloration, or retained fragments are typical of sea urchin envenomations. The venomous spines can inflict burning pain that is initially minor but intensifies over 30 minutes and lasts several hours. The area surrounding the puncture wounds may be red and swollen. Some spines contain a blue-black dye that stains the wound or causes temporary tattooing.

Focal Rashes

An intense red, itchy rash follows contact with a bristle worm.

Contact with feather hydroids and sea anemones induces a mild reaction, consisting of instantaneous burning, itching, and urticaria. Envenomation may result in a lesion with a pale center and an erythematous or petechial ring; this is followed by increasing edema and ecchymosis. Although most lesions resolve in 48 hours, more severe envenomations may result in vesicle formation, which can lead to an abscess, eschar, or hyperpigmentation.

The sting of the fire coral induces intense burning pain, redness, itching, and painful pruritus with large wheals, with central radiation and reactive regional lymphadenopathy. Fire coral (not a true coral) has a razor-sharp lime carbonate exoskeleton that can cause skin lacerations containing exoskeleton debris.

Envenomation from a jellyfish causes immediate pain that may be described as mild to moderate stinging or burning. Pain is followed by the development of an erythematous rash.

Most jellyfish with suspended tentacles create “tentacle prints” or a whiplike pattern of darkened reddish-brown, purple, or frosted and crosshatched stripes in the precise areas of skin contact (Figure 145-2). Vesiculation and skin necrosis may follow and can last 24 hours or longer. Occasionally, there will be residual hyperpigmentation. Tentacles still may be adherent on patient presentation.

Figure 145-2 “Tentacle prints” from the Atlantic Portuguese man-of-war.

What To Do:

Puncture Wounds

To most effectively relieve pain and attenuate some of the thermolabile protein components of the venom, soak the wound in hot (not scalding) water (approximately 45° C [113° F]) for 30 to 90 minutes or longer for pain control. Have the patient use an unaffected limb as a control to test the water temperature and thereby avoid scalding.

During hot water treatment or while waiting for it to be available, infiltrate in or around the wound with 0.5% bupivacaine or 1% or 2% lidocaine without epinephrine to provide further pain control. When necessary, be generous and add narcotic analgesics.

Irrigate larger wounds as soon as possible with a jet lavage of normal saline or dilute 1% povidone-iodine solution (add 10% Betadine to 0.9% NaCl in a 1:10 ratio), and remove visible pieces of spine or debris.

Obtain radiographs to detect any hidden radiopaque fragments of retained stingray, catfish, or sea urchin spines. Ultrasonography may also be used to locate any remaining pieces.

When anesthesia is complete and pain has been controlled, thoroughly explore, débride, and irrigate open wounds.

Remove fragile sea urchin spines using the same technique as for a superficial sliver (see Chapter 153). Care should be taken in removal of these spines, because they are brittle and may crumble in the wounds. Thin retained spines without symptoms generally are absorbed or extruded; therefore, if difficult or impractical to remove, they can be left in place. Every effort should be made to remove spines adjacent to a tendon or joint. If left in place, treatment should include a 7- to 14-day course of nonsteroidal anti-inflammatories (NSAIDs) (if not contraindicated), and, if a severe secondary reaction occurs, prednisone should be prescribed (unless infection is suspected).

Lightly pack larger wounds open for delayed primary closure (see Chapter 143).

Ensure current tetanus prophylaxis (see Appendix H).

Prophylactic antibiotics are not required for minor abrasions, superficial punctures, and superficial lacerations. Injuries with potential for serious infection include large lacerations, deep puncture wounds (particularly near joints), and wounds with retained foreign material.

These infection-prone wounds, and any wound in an immunocompromised individual of any type, require antibiotic treatment. Ciprofloxacin (Cipro), 500 mg bid, or doxycycline (Vibramycin), 100 mg bid for adults, and trimethoprim-sulfamethoxazole (Bactrim/Septra), 8 to 12 mg TMP/kg/day divided bid for children, all prescribed for 3 to 5 days, are the most appropriate regimens for coverage of pathogenic marine microbes. The genus Vibrio is particularly common in the ocean and poses a serious risk for immunosuppressed patients. Rapidly progressive cellulitis or myositis indicates Vibrio parahaemolyticus or Vibrio vulnificus. Also known to inoculate marine wounds are Erysipelothrix rhusiopathiae and Mycobacterium marinarum. In the more severe wounds, the recommended initial parenteral antibiotics include cefoperazone (Cefobid), ceftazidime (Fortaz), gentamicin (Garamycin), ciprofloxacin, ceftriaxone (Rocephin), and cefuroxime (Zinacef).

For infected wounds, obtain both aerobic and anaerobic cultures, and alert the clinical microbiology laboratory that standard antimicrobial susceptibility testing media may need to be supplemented with NaCl to permit growth of marine bacteria. Institute the above-mentioned antibiotics, except for minor wound infections with the classic appearance of erysipelas, which can be treated with erythromycin or cephalexin. Prescribe antibiotics for 7 to 14 days. Hospitalization may be required for severe infections and in those individuals who are immunosuppressed.

Provide pain control with NSAIDs and narcotic analgesics as required.

Follow up all wounds in 1 to 2 days with periodic revisits until healing is complete.

Focal Rashes

For fire coral, jellyfish, hydroid, or sea anemone stings, decontaminate the area with a liberal soaking of 5% acetic acid (vinegar). Less effective alternatives include baking soda or a solution of a dilute (¼ strength) household ammonia. Vinegar and ammonia may be applied continuously by applying soaked compresses until the pain is relieved or for 30 minutes.

The most effective way to control pain is by using hot water (45° C [113° F]) immersion to inactivate the heat-labile protein toxins. Application of vinegar will stabilize any undischarged stinger cells (nematocysts) and prevent further injury.

Any lacerations from fire coral must be anesthetized, explored, and cleansed. Any retained foreign debris must be removed; then the wound should be lightly packed with moist, fine-mesh gauze for delayed primary closure in 3 to 5 days.

After decontamination with vinegar, remove any visible large jellyfish tentacles with forceps or double-gloved hands. Remove small particles by applying shaving foam, or some equivalent, and gently shaving the area with a safety razor, dull knife, tongue blade, or plastic card; then clean with an antibacterial soap and flush with water or saline solution.

Treat any generalized allergic or systemic reactions with antihistamines, corticosteroids, epinephrine, and IV fluids as indicated.

When irritation from sponges, bristle worms, or other marine creatures causes erythematous or urticarial eruptions, it usually means that tiny spicules and spinules are embedded in the skin. Apply vinegar compresses to help neutralize toxins and relieve pain. Dry the skin, apply the sticky side of a piece of adhesive tape to the affected area, and peel the tape back to remove these particles. Cosmetic deep-cleansing strips for skin pores (Bioré Pore Perfect) can also be effective if available. Gauze soaked with glue, applied to the area and allowed to dry, is another method of removing embedded particles when the gauze is peeled away.

Residual inflammation can be treated with topical corticosteroids, such as triamcinolone (Aristocort A) 0.1% or 0.5% cream or desoximetasone (Topicort) emollient cream or ointment 0.25% (dispense 15 g and apply tid to qid). A topical steroid in combination with a topical anesthetic can be additionally soothing (e.g., Pramosone cream, lotion, or ointment 2.5% tid to qid). Systemic antihistamines will also be helpful for pruritus, and, on occasion, systemic corticosteroids will be required.

Tetanus prophylaxis should be administered if indicated.

Provide pain control with NSAIDs and narcotic analgesics as required.

Advise the patient about sun avoidance and the use of sun blocks to prevent possible postinflammatory hyperpigmentation. Hydroquinone (Eldoquin-Forte) 4% skin bleaching cream can be prescribed to be rubbed in bid when hyperpigmentation occurs.

Check wounds for infection in 2 and 7 days.

What Not To Do:

Do not use fresh water or isopropyl (rubbing) alcohol to decontaminate jellyfish stings. It may cause any remaining nematocysts to rupture and trigger additional stinging.

Do not use full-strength ammonia as a substitute for vinegar compresses. It is a powerful skin irritant.

Do not constrict limbs tightly.

Discussion

Many marine animals have developed systems for attack and defense that on accidental exposure to humans result in envenomation. Most envenomations are not life threatening, often presenting only as minor contact dermatitis or a small puncture wound. Venomous marine organisms can be difficult to identify or may not be seen at the time of envenomation.

Marine animals responsible for envenomation can be broken into two large groups—vertebrates and invertebrates. Venomous vertebrate marine animals include stingrays, lionfish, scorpion fish, stonefish, and catfish, whereas venomous invertebrates include jellyfish, anemones, and fire coral.

Treatment can be based on the nature and appearance of the wound when the specific sea creature cannot be identified.

Although one should always be wary of the possibility for anaphylaxis and cardiopulmonary collapse, particularly in elderly victims with previous sensitization to venom antigens, these complications are rarely seen with stings from creatures found in North American waters.

Any wound acquired in the marine environment can become infected, and this is particularly likely if the wound is large, is a puncture, or is contaminated with bottom sediment or organic matter.

Stingray victims are generally innocent beach walkers who step on the back of the ray, which reflexively strikes upward with its tail, inflicting a penetrating wound along the upper foot, ankle, or lower leg. Injuries also are sustained to the hand or arm in the process of trying to remove a stingray that has been caught while fishing. The anatomic structure of the stingray’s spine causes a deep, jagged painful wound that may contain fragments of the barb. This barb is located on the dorsum of the proximal portion of the tail. Submersion of the affected area in hot water (43° to 46° C) may help mitigate the pain: in one retrospective review, 65 (67%) of 97 patients with stingray wounds had complete analgesia with hot water immersion alone. Other remedies, including applying the cut half of an onion (Australian), or urinating on the wound are unproven.

Scorpion fish, lionfish, and stonefish stings occur in divers and fisherman, and sometimes in keepers of marine aquariums or those involved in illegal tropical fish trade. (Intravenous stonefish antivenin is indicated in cases of severe systemic reactions to stonefish.) Catfish stings are common when the fish are handled or kicked. Certain catfish species produce venom in glands at the base of the dorsal spine, but most do not, and catfish venom causes only mild local pain, redness, and swelling. Of more concern is the wound caused by the spine and the likelihood of infection that may take months to resolve.

Sea urchin victims are stung when they step on, handle, or brush up against these sessile creatures. The sea urchin secretes a toxin on the surface of its spines that is transferred into the wound when they penetrate the skin. The brittle spines also tend to break off and remain in the wound.

Jellyfish, sea anemones, and fire coral envenomate their prey through nematocysts (Figures 145-3 and 145-4). Nematocysts are venom-containing stinging organelles located in specialized epithelial cells called cnidocytes. Jellyfish tentacles vary in length from a few millimeters to more than 40 meters. Tentacles that have separated from the jellyfish are still capable of stinging for weeks or months after becoming detached, even if dried.

Figure 145-3 Nematocyst prior to discharging. (Adapted from Stauffer AR, Auerbach PS: Marine envenomations: common Florida injuries. EMpulse 8:12, 2003.)

Figure 145-4 Nematocyst after discharge occurs. (Adapted from Stauffer AR, Auerbach PS: Marine envenomations: common Florida injuries. EMpulse 8:12, 2003.)

Although not as effective as heat or vinegar, papain (unseasoned meat tenderizer or papaya latex [juice]) also have been reported to relieve the pain associated with jellyfish stings. If either is used, it should be applied for no longer than 15 minutes. Isopropyl alcohol (which some suggest may worsen the pain), dilute ammonium hydroxide, sodium bicarbonate, olive oil, urine, and sugar are also described in marine medical literature as potentially effective.

“Safe Sea” sunscreen with jellyfish sting protective lotion (Nidaria Technology, Boca Raton, Fla.) is a commercial product that shows promise as an effective “sting inhibitor” when applied to human skin before jellyfish tentacle contact. This product has been studied in two trials involving human volunteers and has demonstrated a clinically important benefit.

The sea wasp, or box jellyfish, which inhabits the Indo-Pacific Ocean, is the most venomous sea creature and can induce death in 30 seconds. If a patient who is stung by this member of the Scyphozoa survives long enough to receive medical care, sheep antivenom is available.

True and soft corals can cause lacerations secondary to mechanical trauma. There is no envenomation, but wounds often become infected, having poor healing and a persistent exudate. These wounds should be carefully cleaned and débrided and treated with daily wet-to-dry dressings until clean.

Minor bites from octopi, sharks, moray eels, and barracudas are usually the result of the marine creature’s instinct to protect itself against a perceived danger. Treatment is symptomatic; local cleansing and topical dressing usually are adequate. If the wound becomes infected, antibiotics as previously described should be initiated.

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Related

First Aid for Catfish Stings –

First Aid

Catfish stings are caused by a type of ray-finned fish known for their prominent barbells called catfish. Named after their resemblance with cat’s whiskers, catfish have substantial commercial importance. They are served as part of dishes, either fished or farmed, but some species are used in aquarium hobby. Catfish are also popularly called “mud cats,” “polliwogs,” and “chuckleheads.”Catfish can be found in both freshwater and seawater, usually in the shallow, running water of rivers and lakes, and in the shores, respectively. They are can be found in all continents, but Antartica. While most species of catfish are harmless to humans, there are a few species that can sting and cause harm.They have three external spines are located near their fins and a stinger, which may release skin toxin and venom. And although most stings are non-venomous, extra precaution must still be taken to avoid these painful stings. The hand is the most common site of catfish stings. Catfish are not aggressive andthere has only been one reported case of specie of catfish attacking humans.

Causes of Catfish Stings

                Most cases of catfish stings are due to accidents. The most common causes of catfish stings include:

• Accidental direct contact
  • Stepping on the fish while bathing in freshwater bodies of water
  • Improper handling after catching the fish

Symptoms of Catfish Stings

Stings, from any animal, are often very painful to humans. It is fairly obvious when a person has been stung. However, it may be difficult to determine which animal, especially in cases of water animals. Some of the common symptoms of catfish stings are the following:

• History of direct contact with any fish in any form of body of water
• Intense pain
• Inflammation at the site of the sting
• Severe tissue necrosis
• Puncture wounds and scrapes

Call for emergency medical services when the person is experiencing trouble breathing.

How to Give First Aid for Catfish Stings

First aid must be given immediately to alleviate symptoms and reduce discomfort experiences by the person stung. The following is advised to do in cases of catfish stings:

• Immediately get the person out of the water.
• If the victim is not breathing, initiate CPR.

• Remove the catfish spines using tweezers.
• Clean the wound by scrubbing it with fresh water and soap. Rinse thoroughly with fresh or salt water.
• To relieve pain, immerse the affected area in hot water, the hottest temperature a person is capable of. Do this for at least 30 minutes.
• Do not cover the wound or attempt to tape or sew it together.
• Take oral antibiotics for wounds that become infected.
• Pain medications such as, acetaminophen and ibuprofen may be taken every six to eight hours.

Medical emergencies may occur anywhere. And thus, it is highly recommended to join in First Aid Courses before venturing into the wild or other places where medical help may be unreachable immediately. Learning how to treat and manage catfish stings and other stings may help avoid complications and provide comfort to the ailing victim.

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JoDrugs. FISH STINGS

90,000 In Bavaria – a record of infections with tick-borne encephalitis and borreliosis (photo) | Germany Information and Travel Tips | DW

Munich • In 2020, the southern German federal state of Bavaria recorded a record number of cases of tick-borne encephalitis and tick-borne borreliosis since the introduction of mandatory statistics on these infectious diseases.

As of the end of October, 257 cases of spring-summer tick-borne meningoencephalitis (German.Frühsommer-Meningoenzephalitis, FSME), which is 73 cases more than in the previous year, as well as 5880 cases of borreliosis (German Lyme-Borreliose), last year – 3923 cases. This was reported by the dpa news agency, citing data from the land ministry of health.

Tick on a green leaf

Bavaria – risk zone

Due to the increase in these rates, the authorities urged people in Bavaria to get and regularly update vaccinations against tick-borne encephalitis, and also to avoid walking among shrubs, low trees and tall grass, where most often occurs ticks on clothing or exposed areas of the body.

Officially, the encephalitis risk zones include almost the entire territory of this federal state, with the exception of the cities of Augsburg, Munich and Schweinfurt, as well as the districts of Dillingen an der Donau and Fürstenfeldbruck.

Vaccination against spring-summer tick-borne meningoencephalitis (German Frühsommer-Meningoenzephalitis, FSME)

Tick-borne encephalitis vaccination stamp in the vaccination passport

if detected early, this infectious disease usually responds well to antibiotic treatment.After bites, it is therefore very important to monitor the symptoms, one of which is the appearance of a red spot, the diameter of which can usually be from one to ten centimeters.

Among the preventive recommendations – are the use of drugs that repel ticks, a thorough examination of the body and clothes after returning home, as well as regular monitoring while being in nature. Once on the body, the tick does not dig in immediately. It may take several hours until this moment.

Why there are more ticks in Germany

In recent years, as we have already described in detail, the populations of ticks in Germany as a whole have increased markedly.At the same time, the territories of risk zones, where infected ticks are found, have expanded. This is caused by climate change, in particular – by the more frequent warm winter periods.

After abnormally mild winters, the number of ticks in the forests increases dramatically. In addition, in 2020, due to the coronavirus pandemic, many people in Germany spent summer vacations and vacations at home and, in general, spent more time in nature.

See also:

• Dangerous animals in Germany

  Fire salamander

  Fire salamander (lat.Salamandra salamandra) is one of the most common and prominent representatives of the genus of salamanders. The tailed amphibian, reaching 23 cm in length, prefers a cool, humid environment. For humans, the poison of an amphibian is not dangerous, but even a light touch to it causes a burning sensation – the color of the salamander warns of toxicity.

• Dangerous animals in Germany

  Tick

  Among the huge number of species of ixodid ticks (Latin Ixodida) that live in forests, parks and even in the gardens of Germany, there are carriers of dangerous diseases – tick-borne encephalitis and tick-borne borreliosis.Therefore, you should always be afraid of the bite of these bloodsuckers measuring from 2.5 to 4 millimeters, because the consequences may be irreversible.

• Dangerous animals in Germany

  Sea dragon

  Lovers of swimming in the waters of the North and Baltic seas washing the coastal areas of northern Germany, unpleasant surprises await: sea dragons (Latin Trachinidae) like to bury themselves in the sand and sting bathers approaching them … In this case, the victim’s temperature may rise, vomiting may open … To neutralize the poison, you need to pull out the sting, and lower the leg into hot water.

• Dangerous animals in Germany

  Viper

  Only two species of poisonous snakes are found in Germany. One of them is the common viper (lat.Vipera berus). The venom of this small (about 65 cm) snake is stronger than the venom of the American rattlesnake, but the European viper has much less of it – fortunately for those whom this shy snake still bites. The bite is painful, can cause vomiting, headaches, but it is not fatal.

• Dangerous animals in Germany

  Crosspiece

  Almost all spiders are poisonous.But the poison of most of them is not dangerous for humans. It is most powerful in the cross (lat. Araneus), which contains hemotoxin in its venom. For a person, the amount of poison released by the cross is harmless, but the bite can be painful. This spider usually settles in tree crowns: in forests and gardens.

• Dangerous animals in Germany

  Cyanea

  Hairy cyanea (Latin Cyanea capillata) is a real disaster for the inhabitants of the coastal regions of Germany and vacationers.The slightest touch to the fiery beauty in the water or on the shore responds with burning pain: this is how the poison acts, which are supplied with the stinging cells of the tentacles of the jellyfish. Painful shock can even cause cardiac arrest.

• Dangerous animals in Germany

  Catfish

  European catfish (Silurus Glanis) feels great in Germany. Some individuals reach 150-190 cm in length. Such a catfish may well bite, especially if the bather accidentally steps on the nest or is near it.In small pits in shallow water, before spawning, females equip nests, which males then guard. A catfish bite is not hazardous to health.

• Dangerous animals in Germany

  Wasp, hornet, bee …

  If you have an allergy, the bite of nectar hunters can be fatal. But even those who, for example, disturb the nest of wasps or hornets, will not be good. It’s all about the number of bites, which means the dose of the poison received. In the picture: common hornet (lat.Vespa crabro). Despite its impressive size (up to 35 mm), the hornet is considered less aggressive than the wasp.

• Dangerous animals in Germany

  Wild boar, wild boar … game

  Germany is a country of forests. It is clear that there is plenty of game in them. So, it may not be good to someone who “crosses the road” of a wild boar or a wild pig with a brood. Such unwanted encounters are extremely rare – the wild boar usually avoids them on its own. But if they do happen, it is important not to touch the brood or photograph it, avoid fussy movements and try to quietly leave.

• Dangerous animals in Germany

  Dogs and cats

  Pets are not always friendly. Every year in Germany, several thousand dog or cat bites are recorded – in 90 percent of cases, these are either their own pets or animals of friends. The likelihood of being bitten by a stranger’s dog on the street is small – in Germany, it is customary to walk dogs only on a leash, with the exception of specially designated lawns in parks.

  Author: Inga Wanner

90,000 Entomologist of Moscow State University explained what to do in case of a tick bite

Anastasia Antonovskaya, a specialist in red tick ticks, an employee of the Department of Entomology, Faculty of Biology, Moscow State University, said that in her opinion one should not do with tick bites, how to pull them out correctly and how dangerous these arachnids are.

– Can a tick be confused with a blood-sucking insect?

In general, in Russia, hardly anyone else can dig in as much as the ixodid tick does. They have a characteristic shape: almost oval and flat, a semicircular shield, no head. What sticks out can rather be called a proboscis. These are the jaws enclosed in a case. Other ticks can also attack a person (and here they can be easily confused with something else, because these others are rather small arachnids).But you will recognize ixodid ticks right away. In principle, the so-called moose flies (Hippobosca spp.) Are a bit like them, after they have thrown off their wings, but they are more stocky and thicker. And, unlike ticks, they have a head with eyes. At the beginning of summer in central Russia, you are unlikely to meet them.

– If a tick has stuck, what is definitely not worth doing?

Almost no scientific research has been carried out on effective methods for removing ticks.But don’t wait for the tick to fall off on its own. Also, do not smear with oil, set it on fire or bring a hot match. These methods will do more harm than good: either they will contribute to the development of inflammation, the introduction of unnecessary microflora (after all, when eating, the tick cuts through the skin, a wound is formed), or they additionally damage the skin. Do not take antibiotics right away.

If one tick has bitten, it is possible that several more are sitting on you somewhere. Once in the mountains of Abkhazia, 10 ticks attacked me – there was a high number of them.So it would be nice to take a close look at other parts of the body and at the clothes – suddenly there are other ticks lurking there.

Don’t panic yet. If you decide to search the Internet for help, remember that not all people who write there are qualified doctors. Check sources. Go to the website of Rospotrebnadzor or the Department of Health. Call the hotline.

– How to remove a tick correctly? Would you like tweezers or a thread? Is it also possible to catch from the sides or from the abdomen and back?

Personally, I have never tried threading.It seems to me that this is more likely to tear the proboscis from the body. But it depends on how far you are from civilization, and what you have at hand. With tweezers, you can grab the abdomen and back, closer to the base of the proboscis – there the tick has rather dense integuments.

After grabbing, pull the tick with even force. You can twist it (clockwise or counterclockwise – it doesn’t matter). There is evidence that this is a faster method, but the teeth break off more often.The jaws of the tick are armed in the form of backward-facing teeth: like some types of arrows – to make it more difficult to pull out. And physical strength will not help here. Only cunning and patience.

It is also possible to swing the tick in the wound and carefully pull it out, but there is a risk of breaking the jaw. It is not necessary to abruptly drag the tick out of the wound. Although I repeat once again that there is no uniquely effective way. By the way, special loops for tick removal are sold in pharmacies. It might be worth buying one.

– What if the tick’s body came off, but the proboscis remained inside?

You need to take a needle or tweezers, wipe them with alcohol, or at least wash them with soap and water – and carefully pull out the proboscis. If a very small fragment remains, you can simply treat the wound with an iodine solution. If you have problems, it is better to go to the emergency room, where doctors will provide qualified assistance.

– The tick was safely removed. What to do next?

Treat the wound with a disinfectant such as iodine, betadine, or hydrogen peroxide.Most likely there will be inflammation at the site of the bite, it may itch (no need to scratch).

As soon as you pulled out the tick, put it immediately in a test tube or in a jar with a tight-fitting lid. It is advisable to always keep the tick that bit you. In general, if there are any doubts: whether the tick was removed correctly, whether you will get sick, call the Department of Health or the Institute of Epidemiology. The website of the Moscow City Health Department has key information: hospital addresses, phone numbers.At the Institute of Epidemiology on Novogireevskaya Street, you can take a tick for analysis (CMD laboratory). They also have a hotline “Beware of ticks!”

If the test results show that the tick was not a carrier of either borrelia or tick-borne encephalitis virus, you should monitor your health and probable symptoms for at least a month. Diagnostic errors can happen.

– How can you get infected from a tick and how great is the likelihood of catching an unpleasant disease from it?

The danger and likelihood of getting sick with something unpleasant depends not only on your body, but also on which part of the world you were bitten by a tick.Our country is large, and there are a lot of different landscapes and conditions in which this or that focus of the disease can develop. The most famous and widespread diseases in Central Russia, with which ixodid ticks are associated, are viral tick-borne encephalitis and Lyme borreliosis.

You can only make sure everything is in order if enough time has passed since the bite. At least 30 days. The tick-borne encephalitis virus can show up after 60 days, although some people are asymptomatic.Borreliosis is unpleasant with possible complications when the pathogen spreads to the myocardium, muscles, joints, even to the brain. So if you have symptoms, go to the doctor at the infectious diseases hospital, or call the hotline, they will tell you which antibiotic to drink. Let me remind you that antibiotics are powerless against the tick-borne encephalitis virus, so if there are suspicions, you should immediately go to the hospital.

– How to check if there is tick-borne encephalitis in the region, and how to notice its first symptoms?

The Rospotrebnadzor website has a list of endemic areas for tick-borne encephalitis.Check if there is one where the tick bit you. If there are many cases in the territory, and you do not have a vaccination against the strain that is widespread there, call the hotline of the infectious diseases hospital (in Moscow, it seems to be the 2nd, and for children – the Filatovskaya hospital). Within 4 days after the bite, emergency seroprophylaxis can help when specific antibodies against tick-borne encephalitis virus are administered.

Virus strains spread across different territories can lead to serious consequences (paralysis or even death) with varying probability.From this point of view, the Far East is more dangerous than the European part of Russia. So you need to closely monitor your health after a tick bite for at least 2 weeks. Tick-borne encephalitis begins abruptly with a strong fever, severe headaches, vomiting, nausea, muscle pain, often reddened face, body parts. By the way, in Europe, the tick-borne encephalitis virus strain causes very mild symptoms and is much less dangerous than in Russia.

– How does borreliosis manifest itself?

Within 30 days after a tick bite, you need to monitor your condition.Typical symptoms of borreliosis are a papule at the site of the bite, redness, erythema on the body, and fever. Typically, the incubation period for infection lasts 10-14 days. At this time, weakness, malaise, muscle and joint pain may be observed.

More about Borrelia. Even if the percentage of borrelia-infected ticks in a region is high, this does not always mean that you will definitely get sick when an infected tick bites. Only 5-7% of ticks infected with borrelia have bacteria in the salivary glands.This means that they cannot enter the body when bitten.

If a sucked tick with borrelia in the intestines or gonads is crushed or damaged, then they can be brought into wounds on the skin or mucous membranes, and thus become infected. So it is necessary to remove the tick carefully. There are also cases of short-term and imperceptible bites of males: he bit and ran further. However, the male can transmit Borrelia through such bites.

– Is it possible to get infected with anything other than borreliosis and tick-borne encephalitis after a bite?

There are many more diseases around the world that are associated with ticks.Of those that are found in Russia, for example, Crimean hemorrhagic fever is widespread (these are areas located in the steppe, forest-steppe zones, for example, Rostov, Astrakhan regions, Stavropol Territory, Kalmykia, etc.). Its causative agent is also a virus. There is also Omsk hemorrhagic fever, Kemerovo fever, Q fever (rickettsiosis), etc. Therefore, the risk of infection depends on where and how you live, work or play. Various mixed infections also occur (when a person becomes infected with not one, but several pathogenic microorganisms).

– And if you find a tick on your pet, follow the same algorithm?

Yes, unscrew it by gently loosening it. Unfortunately, I have no pets, so I can’t say anything from my experience. Animals also get sick, with borreliosis in particular. The main thing is not to be afraid, to act immediately and quickly. For pets, there are special pills that, after taking them inside, scare away ticks from the dog. I think everyone who has a dog or cat goes to a veterinarian who knows much more about ticks and animal diseases than I do.

Acute scrotal syndrome in boys

The most common reasons for referring to a pediatric surgeon are acute surgical diseases and injuries in children. Any emergency, especially if it requires the intervention of a surgeon, is a legitimate concern for parents. It is very important for a number of diseases or injuries to consult a pediatric surgeon in a timely manner so that qualified assistance is provided as quickly as possible.

One of these reasons is diseases of the scrotum organs in boys .These diseases are combined into one group called “scrotal edema syndrome” (SOM).

This syndrome is characterized by symptoms common to all diseases of the group:

• scrotal edema, sometimes very pronounced;

• hyperemia (redness) of the skin of the scrotum;

• severe pain in this area.

In addition to these symptoms, fever, nausea and vomiting may occur with SOM.

Edema and hyperemia of the scrotum without pain are sometimes signs of an allergic reaction, but only a surgeon or a very experienced pediatrician can distinguish an allergy from COM. Parents should never rely on their own impressions or information from the Internet!

Some of the most common diseases that cause this triad of symptoms are testicular torsion, testicular torsion, orchitis (or epididymitis orchiditis).

Most formidable condition – testicular torsion .This disease occurs in 1 in 500 patients with SOM. Most often occurs in boys and adolescents aged 11-15 years, but can occur at an early age and in a newborn (in about 10% of cases). In addition, intrauterine testicular torsion occurs, leading to organ atrophy.

The disease occurs when, due to a number of anatomical and physiological characteristics or under the influence of external factors, the testicle rotates around its own axis, which leads to volvulus of the blood vessels going to it.As a result, the blood supply to the testicle is significantly impaired. This condition is accompanied by sharp pains in the scrotum, vomiting, then edema and hyperemia appear. Delay is unacceptable here! Only an urgent visit to the surgeon and immediate vigorous treatment can save the testicle from necrosis (death). In the vast majority of cases, only urgent surgery allows the surgeon to correct the torsion and restore the blood supply to the testicle. An extremely insidious symptom is pain relief a few hours after it occurs.This may mean the onset of death of the testicle, and not improvement against the background of unqualified treatment.

A much more common cause of SOM is torsion of the hydatid testis or its epididymis. This disease is the cause of SOM in about 45% of patients and can occur at any age. Testicular gidatida is a small remnant of embryonic tissue that is connected to the testis in the form of an “earring” on a thin stem. Torsion of the hydatids leads to the appearance of symptoms characteristic of COM: pain in the scrotum, its edema and hyperemia.Unlike testicular torsion, the pain syndrome is less pronounced, and the characteristic symptoms do not develop so rapidly. Treatment is only operative: it is necessary to remove the twisted hydatidum, otherwise the inflammation will go to the testicle itself, which subsequently will certainly affect the ability to bear children.

Orchitis (epididymitis) , an inflammation of the testicle (or its epididymis), can occur in children of any age. Very often it develops against the background of various viral diseases. A typical example of infectious orchitis is with mumps.Chronic lower urinary tract infection can also lead to orchitis. In most cases, surgical treatment is not required. Antibacterial and symptomatic therapy can effectively cure a child.

Ultrasound of the scrotal organs helps in the diagnosis of COM. When contacting the EMC Children’s Clinic, an ultrasound scan is always performed for a child with COM. Ultrasound may reveal testicular torsion or hydatids, signs of inflammation of the testicle and its epididymis. But any of the existing high-tech methods does not replace, but only complements the examination by a surgeon, whose experience and qualifications play a decisive role.EMC pediatric surgeons, based on clinical data and ultrasound results, make an informed decision about the need for surgery.

In most cases, treatment with SOM does not require long-term hospitalization. In our clinic, children operated on for uncomplicated forms of SOM are usually discharged home on the day of surgery or the next day. Of course, the treatment does not end there. At home, you must strictly follow all the doctor’s prescriptions.

It is important to remember that the onset of symptoms of acute scrotal syndrome requires an early referral to an experienced pediatric surgeon.The specialists of the Department of Pediatric Surgery of EMC are ready to consult the child and carry out the necessary treatment at any time of the day.

Dermatology – VetaLeX – Veterinary Center Izmail

My dog ​​itches a lot, gnaws at itself. There are tubercles on the back. Most likely “Subcutaneous tick”. We were treating, but nothing helps.

It is not uncommon for pet owners to notice that their dog begins to scratch or gnaw heavily on itself.As practice shows, many of them do not attach much importance to this, or they simply go to a pet store or veterinary pharmacy buying the cheapest flea collar, assuming that this will definitely help. In fact, if a dog itches, gnaws itself, there may be many reasons. It can be dermatological, parasitic, fungal, hormonal diseases, different types of allergies, psychological conditions or stress.

Reasons for the dog scratching and chewing itself.

• Flea allergy. This condition most commonly results in multiple scratching of the dog’s skin resulting from itching. As a rule, dogs suffering from flea allergies scratch and try to chew on their back, tail, belly, and paws. In order for the disease to begin to deliver such discomfort to the pet, one flea bite is enough. Regular flea treatment will help prevent this condition of the animal.
• “ Subcutaneous mite” or, more correctly, disease Demodectic mange .Demodex is a small mite that lives in the skin of dogs and other animals and normally does not cause any diseases. Normally, the immune system is able to control the number of mites on the skin, so the disease does not develop in healthy animals. If there are serious disorders in the functioning of the immune system, the body loses its ability to control the number of ticks and a disease called demodicosis occurs. Thus, canine demodicosis is NOT INVOLVED, that is, it is not transmitted from dog to dog, since each animal has its “own” ticks, and whether the disease occurs or not depends on the animal’s immunity.Most often, puppies are sick up to a year. The first signs of the disease are usually the so-called bald patches, most often in the head and paws. Itching, as a rule, is not pronounced, and appears only with an attached bacterial infection, which is not uncommon with demodicosis. In advanced cases, the animal can become completely bald, a severe purulent or fungal infection can join, and the general condition of the animal can be quite severe. Self-medication of such a disease can lead to consequences.In addition to demodicosis, there are many other parasitic diseases such as sarcoptic mange, otodectosis (ear mites), heiletiosis, etc. Therefore, it is better to contact a veterinarian who will diagnose on the basis of laboratory tests (scraping from the skin) and prescribe the correct treatment that will not harm the pet’s health.
• Lice are whitish chewing lice that, like fleas, can cause itching in a dog. How do you know if a dog is affected by lice? To begin with, you should carefully consider the pet’s fur and skin: wiggling light straw dots no more than 4 mm long are lice.Outwardly, they look like fleas, but their color is much lighter. Signs of the presence of lice – constant scratching (special itching can be in the ears, genitals, and also where the hair is especially long), inflammation of the skin from the bites of the parasites themselves and from the teeth of the animal itself, deterioration of the condition of the coat (the appearance of tangles, thinness and dullness hairs), insomnia.
• Vlasoids are light yellow insects that can inhabit the coat of a dog. A disease that develops against the background of the presence of lice is trichodectosis.Signs of the presence of these parasites are itching (especially in the area of ​​the ears, abdomen and thighs, base of the tail), thickening and coarsening of the skin, deterioration of the coat, bald patches. Actually, the symptoms of the presence of lice are similar to those that occur with lice;
• Food allergy is a common condition that is also partly manifested by severe itching. As a rule, in order to eliminate this symptom, it is only necessary to determine the product that causes a similar reaction in the body and completely exclude it from the dog’s diet.
• Allergic reaction to insect bites . This type of allergy is much less common than other types of allergy. But if the pet is still susceptible to it, it will itch and gnaw itself in the bite zone.
• Contact allergy is an inappropriate response by the body to an irritant that comes into contact with the animal’s epidermis. It is usually characterized by the onset of severe itching in the area of ​​the pet’s peritoneum or chest.
• Moist Dermatitis .With this disease, redness develops on the dog’s skin, which is actually a bacterial infection that can cause very severe itching. As a result, the pet begins to comb and gnaw, lick the inflamed areas, which, of course, causes even greater damage and itching.
• Bacterial skin lesions – the most common ailment caused by various bacteria (staphylococci, streptococci, etc.) is considered to be pyoderma. Signs of such a disease are severe itching and inflammation of the skin, the formation of purulent papules, erosions and even ulcers on the skin of the body (incl.including in the interdigital space), dandruff, the appearance of an unpleasant putrid odor from the dog’s skin, hair loss in the affected areas, weakness, refusal to feed, apathy.
• Mental disorder, stress – if the dog itches, but there are no fleas, as well as ticks and other ectoparasites, the reason may lie in an emotional disorder. Some people believe that stress is a human problem, but dogs can also suffer as much as we do, for example, from a sudden change of place of residence, betrayal by the owner, or the appearance of a new family member (child or other pet) in the house.Signs of stress – not only scratching, but also licking the body up to the receding hairline (paws and the base of the tail usually suffer).

What to do if the animal itches?

Consult a veterinarian! Unfortunately, it will not work to determine “by eye” what the dog is sick with. Do not self-medicate! This can harm your pet’s health!

90,000 European catfish (Silurus glanis) rearing in water recirculation systems

Dariusz Ulikowski

Department of Lake Fisheries in Gizycko Institute of Freshwater Fisheries in Olsztyn

Introduction

The European catfish (Silurus glanis) is the largest predator of our freshwaters, usually found in large low-lying rivers and warm eutrophic lakes (Choroszewicz 1971).It is a valuable object for pond farming, especially when it is used as an additional fish in polyculture, since it eats unnecessary small fish, which are fodder competitors of economically valuable fish. Catfish as a thermophilic species are intensively reared in cages in water discharged from cooling systems of power plants. It is at this kind of facilities in Poland that commercial catfish is produced – 100-300 tons per year (unpublished own data).

The optimal stock of catfish for rearing in cages is juveniles with an average body weight above 10 g.Obtaining such fish is possible in the course of rearing in pools and feeding with high-protein granulated feed. Catfish larvae and juveniles are highly susceptible to bacterial infections and parasitic diseases, which requires frequent use of preventive and therapeutic procedures. The risk of catfish disease can be reduced by maintaining a high water temperature (above 28 ° C) during rearing; Such a temperature, on the one hand, ensures a high growth rate of fish, and on the other hand, it limits or makes impossible the reproduction of some pathogenic protozoa dangerous for catfish.This is another argument for raising catfish larvae and juveniles in systems with a closed water circuit.

The main advantage of these systems is the ability to control the growing conditions (maintaining high water temperatures) and conveniently control the feed intake, as well as monitor the health of fish. Some problems related to catfish rearing have been partially discussed by many authors (Heymann 1990, Wol-nicki 1995, Kaminski and Wolnicki 1996, Wolnicki and Starzonek 1996, Wolnicki and Kaminski 1998, Poczeczyñski et al.2000, Ulikowski 2000, 2002, 2003a, 2003c), but the technology of rearing this species in a full cycle using closed systems has not yet been described.

The purpose of this article is to present the most important problems related to the technology of intensive rearing of European catfish in recirculation systems developed at the Experimental Station “Dgal” of the Institute of Freshwater Fisheries in Olsztyn.

Equipment for closed systems used for raising and fattening catfish:

A system with a closed water circuit for raising and fattening catfish consisted of the following components:

• fish breeding pools; a water purification system with biofilters and a sedimentator or microsieve, which ensure the maintenance of the appropriate water quality; thermoregulation system for heating water and maintaining its specified temperature; water recirculation system equipped with pumps; sources of electricity.

For raising and fattening catfish, different types of pools were used. As a rule, these are containers made of artificial materials. We also used concrete pools. In addition to the systems listed above, devices enriching water with oxygen play a significant role in intensifying catfish rearing in closed systems (see photo on the right).

Their use allows you to increase the stocking density even 3 times during the rearing in the pools. A very significant factor influencing the successful results of rearing catfish in a closed system is the maximum darkening of the pools for rearing fish.For larvae and juveniles, the clarification rate should be less than 0.01 lux, and for large fish less than 0.1 lux (unpublished own data).

Catfish rearing process

In the production of catfish in closed systems, three successive stages can be distinguished: rearing the larvae to the juvenile juvenile stage, then rearing these juveniles to the stage of grown-up juveniles, and finally, feeding the latter to obtain marketable fish.

At the first stage, the purpose of rearing larvae is to obtain juveniles with an average body weight of 1 g.At the beginning, the newly hatched larvae are usually kept in receptacles, where they resorb the contents of the yolk sacs, and then they are fed with compound feed. Larvae can also be kept and reared in special cages, in this case labor costs and fish losses during rearing are reduced (Ulikovski 2003c). The planting density at the first stage should not exceed 20,000 pcs / m (Ulikovski and Borkowska 1999).

Rice. 1. Growth and feeding curve at the first stage of intensive rearing of catfish in a closed system

Juvenile catfish grow very quickly under optimal conditions and assimilate well the artificial compound feed supplied to them, as evidenced by the obtained feed ratios (FCR = 0.4-0.6).After reaching the individual value of 1 g, sorting into two groups should be carried out, and you can use the simple sorting baskets used in the Dgal Experimental Station (Ulikovski et al. 2000).

The second stage of juvenile rearing should be carried out keeping the same conditions as during the first stage, and at least until the time of the next sorting, which we carry out after the fish reaches an average weight of 10 g.

The stocking density at this stage of rearing should not exceed 3000 pcs / m.In the following weeks, the water temperature can be reduced to 26-28 ° C. This makes it easier to prepare fish for sales occasions. Approximately on the 60th day of rearing, the planting should be defused to 500-1000 pcs / m. After 100-120 days from the moment of hatching, the fish should reach an average body weight of 100 g. Feeding is carried out according to the feeding curve shown in Fig. 2.

Rice. 2. The growth of fry and the feeding curve at the next stages of intensive rearing of catfish in a closed system.

The third sorting is carried out when the fish have reached an individual value of 100 g. The survival rate at the stage from 1 to 10 g depends mainly on how the catfish will tolerate the invasion of protozoa parasites. In the best case, it can exceed 90%, and a similar picture is observed at the next stage of growing, i.e. from 10 g to 100 g. Fodder coefficients with proper feeding are markedly low (FCR = 0.7-0.9), which indicates good feed digestibility at this stage of rearing as well.

The last stage of feeding catfish fry is aimed at obtaining marketable fish with an average body weight of 1.2-1.5 kg. Sorted by size, juveniles of catfish are placed in pools at a stocking density of 100-200 pcs / m2. The fish are fed with granulated compound feed (with an optimal protein content, i.e. more than 45%, and fat – less than 16%). The entire production cycle, from larva to marketable fish, under optimal rearing conditions can last 7-8 months (Fig. 2). Individuals with an average body weight of 1.1 kg were recorded on the 215 days of feeding (Ulikowski 2003a), and the final biomass can even go up to 150 kg / m2.

Hot moments of catfish growing and disease prevention

The European catfish, due to its susceptibility and high sensitivity to various diseases, has always been considered a difficult species for long-term rearing. Its sensitivity is largely due to the lack of scales on the body, which is why the skin of the catfish is more exposed to attacks by parasitic protozoa than other fish. Therefore, the rearing of catfish larvae was usually carried out only for 1-2 weeks. The key to successful long-term rearing of catfish in closed systems is maintaining optimal rearing conditions and constant monitoring of the health of the fish.Of particular importance are the so-called hot moments in growing, i.e. periods when it is necessary to respond extremely quickly to emerging threats.

The first such period appears between 4 and 7 days, when individuals with a violation of the tail part of the body (white spots and bite wounds) may appear. This happens, in all likelihood, because it was at this time that distinct teeth appear on the jaws of the fish, which protrude even outside the mouth. The second period with similar signs in fish and additionally appearing sometimes swelling of the gill covers appears between the 11th and 14th days of rearing.This time it is due to the multiplication of bacteria in the water. Preventive baths, carried out using Chloramine (10 g / m3), and supplied to the entire volume of the water system, prevents the intensification of these symptoms and limits losses. At the Dgal Experimental Station, this procedure is applied as needed, sometimes daily, or prophylactically every 2-3 days during the first two weeks of growing and once a week during further growing. From many years of experience of the author using different chemicals, it can be stated that Chloramine is the best preventive agent.The fact that it is not caused to the destruction of the bacterial flora of biological filters, the effectiveness of which decreases only for a few hours after the Chloramine supply, seems to be especially significant. This substance causes a decrease in the turbidity of the water (own observations). It should be noted that Chloramine T should be used, since it is less harmful than Chloramine B, which was used earlier in Poland (Terech – Majewska et al. 2004).

Usually the European catfish weighing more than 5 g is often attacked by their most formidable enemy – Ichtyophthirius multifilis.This is the key to growing up. It is very important to state the presence of parasites as early as possible, when their number on one fish does not exceed several pieces. Only in this case, using the recommended therapeutic baths (Antychowicz 1996), can the disease be expected to be mild and the fish can be quickly cured. Therefore, monitoring the health of fish should be carried out continuously, at least twice a week. This parasite is easiest to spot by flashlight on fish feeding on the walls of the pools.A particularly careful examination should be carried out in the case of fish that have just died or are weakened. In conditions of mass production, the invasion of this parasite appears sooner or later. However, after effective treatment, the fish acquire resistance to its re-invasion for a period of several weeks. Usually, recurrent outbreaks are mild and easier to treat. Underestimation of this parasite often leads to the mass death of catfish.

The developed rearing technology allows the production of this valuable species in a closed system.However, from an economic point of view, it seems essential that the production of catfish in these systems should focus only on the production of seed material intended for further rearing in ponds or cages. From many years of experience it follows that the optimal individual size of such a planting material is 10 g.

Literature

1. Antychowicz J. 1996 – Choroby i zatrucia ryb – Wyd. SGGW Warszawa: s. 359. Heymann A. 1990 – Intensivzucht des Welses (Silurus glanis) in Warmwasser mit Trockenfutter – Z.Binnanfisch 37 (12): 382-384. Horoszewicz L. 1971 – Sum – PWRiL Warszawa: s. 171. Kamiñski R., Wolnicki J. 1996 – Udany podchów wylêgu suma, Silurus glanis L., na paszy sztucznej w skali pó³technicznej – Komun. Ryb. 6: 4-6. Poczyczyñski P., Ulikowski D., Chybowski £., Wzi¹tek B. 2000 – Porównanie przydatnoœci trzech komercyjnych starterów pstr¹gowych do podchowuw suma europejskiego (Silurus glanis wazdac) (Silurus glanis L. -208.
2. Terech-Majewska E., Grudniewska J., Goryczko K., Kolman H., Kazuñ K., G³¹bski E., Siwicki A.K. 2004 – Chloramina T i B – zastosowanie w akwakulturze – W: Rozród, podchów, profilaktyka ryb jesiotrowych i innych gatunków (Red.) Z. Zakêœ i in. Wyd. IRS Olsztyn: 195-199. Ulikowski D. 2000 – Nowe mo¿liwoœci produkcji materia³u zarybieniowego suma (Silurus glanis) – W: Rybactwo Jeziorowe (Red.) A. Wo³os, Wyd. IRS Olsztyn: 103-107. Ulikowski D. 2002 – Intensyfikacja produkcji materia³u zarybieniowego suma europejskiego (Silurus glanis) – W: Wybrane problemy Rybactwa w 2001 roku (Red.) A. Wo³os, Wyd. IRS Olsztyn: 131-138. Ulikowski D. 2003a – Towarowy tucz suma europejskiego (Silurus glanis L.) w obiegach recyrkulacyjnych – Komun. Ryb. 2: 10-12. Ulikowski D. 2003b – Wybrane aspekty rozrodu i wstêpnego podchowu suma europejskiego Silurus glanis L.) – W: Ryby drapie¿ne. Rozród, podchów, profilaktyka (Red.) Z. Zakêœ i in. Wyd. IRS Olsztyn: 61-67. Ulikowski D., Borkowska I. 1999 – The effect of initial stocking density on growth of European catfish (Silurus glanis L.) larvae under controlled conditions – Arch.Pol. Fish. 7 (1): 151-160. Ulikowski D., Borkowska I., Chybowski £. 1998 – Use of frozen zooplankton in the intense rearing of European catfish (Silurus glanis L.) larvae – Arch. Pol. Fish. 6 (1): 97-106. Ulikowski D., Hliwa P., Szczepkowski M., Szczepkowska B. 2000 – Selekcja wielkoœciowa a p³eæ suma europejskiego, Silurus glanis L. – Komun. Ryb. 2: 12-13. Wolnicki J. 1995 – Ocena przydatnoœci pasz komercyjnych i cyst artemii w kontrolowanym podchowie wylêgu suma, Silurus glanis L. – Komun. Ryb. 1: 11-12.Wolnicki J., Kamiñski R. 1998 – Technologia produkcji materia³u zarybieniowego suma europejskiego na paszach przemys³owych – W. Rybactwo jeziorowe, rozwój, zmiany, trudnoœci (Red.) A. Wo³os. Wyd. IRS Olsztyn: 91-96. Wolnicki J., Starzonek I. 1996 – Mo¿liwoœci wykorzystania starterów pstr¹gowych i cyst artemii w kontrolowanym podchowie larw suma, Silurus glanis L. – Komun. Ryb. 1: 21-24.

“Dangerous infection”: what is the threat of infection with hantavirus

A resident of China died as a result of infection with hantavirus.Previously, the media paid little attention to this infection – at the same time, doctors emphasize that it has been studied and is not as scary as it might seem. About what hantavirus is and how it can be dangerous – in the material of “Gazeta.Ru”.

On March 23, in China, a passenger on a bus en route from Yunnan Province to Shandong felt unwell – an ambulance was called for him. The man died three hours after hospitalization. It turned out that the cause of his death was the hantavirus.

After the incident, the media began to call this infection “new” and even compare it with the coronavirus.At the same time, according to the international medical reference book MSD, hantavirus has been known to science for several decades and has been studied for a long time.

What is Hantavirus?

According to the MSD handbook, infection with hantavirus causes symptoms similar to the common cold: fever, muscle pain and nausea. Difficulty breathing is sometimes recorded. Typically, symptoms appear within two to four weeks after infection. At the same time, unlike a simple ARVI, with hantavirus, a runny nose and sore throat are extremely rare.

As reported in a medical reference, the virus has two main manifestations – pulmonary syndrome and hemorrhagic fever.

In pulmonary syndrome, which is most common in the United States, South America and Panama, in addition to the symptoms described above, hypotension and pulmonary edema may occur.

Also, hantavirus in some cases contributes to the rapid filling of the lungs with fluid, which can be fatal – according to the MSD handbook, mortality in such cases reaches 50%.

However, most often the disease of the pulmonary type resolves without complications and the patient recovers completely within two to three weeks after the onset of symptoms.

In turn, hemorrhagic fever caused by hantavirus begins most often suddenly – with high fever, headache, as well as back and abdominal pain. However, according to the MSD handbooks, in the mildest forms, it can go completely asymptomatic.

Patient recovery usually takes three to six weeks, but in severe cases it can take up to six months.Deaths account for 6-15% of infections and, as a rule, occur in people with the most severe forms of the disease.

Can I get it?

According to the US Centers for Disease Control and Prevention, hantavirus is most often transmitted through the respiratory tract, eyes or mouth after contact with animals (in particular with rodents), as well as after their bites.

Human-to-human transmission is extremely rare, so it will be difficult to get infected with hantavirus in everyday life.

The main precautionary measure can be the exclusion of contact with wild and stray animals.

Is it worth worrying?

Although hantavirus can be fatal, it is still not very widespread in the world.

“Hantavirus does not cause such large epidemics as the coronavirus COVID-19 has now caused.