FEATURES OF THERAPY FOR ACUTE POISONING WITH JELLYFISH POISON (CLINICAL OBSERVATION)
- Authors: Shilov V.V.1,2, Lukin V.A.1,2, Pivovarova L.P.2, Gromov M.I.2
-
Affiliations:
- I.I. Dzhanelidze Research Institute of Emergency Care, Department of Clinical Toxicology
- I.I. Mechnikov North-Western State Medical University, Department of Toxicology, Extreme and Diving Medicine
- Issue: No 5 (2020)
- Pages: 38-42
- Section: Articles
- Published: 05.11.2020
- URL: https://rjsvd.com/0869-7922/article/view/641256
- DOI: https://doi.org/10.36946/0869-7922-2020-5-38-42
- ID: 641256
Cite item
Full Text
Abstract
Jellyfish, as representatives of marine fauna, contain toxic chemicals in their bodies and, if they come into contact with humans, can pose a threat to their health and safety. The article describes a clinical observation of a patient who received a chemical injury as a result of contact of the right upper limb with a venomous jellyfish (Medusa kornerot) and was hospitalized for 35 days with acute poisoning with animal toxin, chemical burns, toxic-allergic dermatitis, epidermolysis, soft tissue necrosis and compression-ischemic neuropathy. Laboratory results confirmed the presence of an inflammatory process, but without allergic and autoimmune components (leukocytosis 16,7 x 109/l, acceleration of ESR to 21 mm/h), revealed an increase in the level of transaminases upon admission: alanine aminotransferase 138.3 u/l (norm 0-31 u/l), aspartate aminotransferase 94,8 u/l (norm 0-31 u/l), gamma-glutamyltransferase 97 u/l (norm 0-32 units/l). Previous drug therapy, including the introduction of tetanus serum (once), antihistamines (chloropyramine), hormonal (prednisone), anticoagulants (heparin sodium), antispasmodics (Metamizole sodium, pitofenone hydrochloride, fenpiverinium bromide), antiplatelet agents (pentoxifylline, nicotinic acid), calcium gluconate, multivitamins in therapeutic doses, the application of bandages «gelonet», «fibrotul Argentum», was not effective enough. Complex therapy with cellular metabolism regulators, antihypoxants, cholinesterase inhibitors using hyperbaric oxygenation and membrane plasmapheresis allowed to achieve a lasting effect: to stop the pain syndrome, normalize the disturbed functions of internal organs and the affected limb, avoid surgery, and fully restore working capacity. This complex of therapeutic measures should be used in the treatment of patients with this pathology
About the authors
V. V. Shilov
I.I. Dzhanelidze Research Institute of Emergency Care, Department of Clinical Toxicology; I.I. Mechnikov North-Western State Medical University, Department of Toxicology, Extreme and Diving Medicine
Author for correspondence.
Email: vshilov@inbox.ru
Shilov Victor Vasilevich
192242, Saint Petersburg
195067, Saint Petersburg
Russian FederationV. A. Lukin
I.I. Dzhanelidze Research Institute of Emergency Care, Department of Clinical Toxicology; I.I. Mechnikov North-Western State Medical University, Department of Toxicology, Extreme and Diving Medicine
Email: Vadim.Lukin@mail.ru
Lukin Vadim Anatolevich
192242, Saint Petersburg
195067, Saint Petersburg
Russian FederationL. P. Pivovarova
I.I. Mechnikov North-Western State Medical University, Department of Toxicology, Extreme and Diving Medicine
Email: pivovaroval@yandex.ru
Pivovarova Ludmila Pavlovna
195067, Saint Petersburg
Russian FederationM. I. Gromov
I.I. Mechnikov North-Western State Medical University, Department of Toxicology, Extreme and Diving Medicine
Email: sekr@emergency.spb.ru
Gromov Michail Ivanovich
195067, Saint Petersburg
Russian FederationReferences
- Cegolon L., Heymann W.C., Lange J.H., Mastrangelo G. Jellyfish stings and their management: a review. Mar Drugs. 2013; 11(2): 523-50. Available at: 10.3390/md11020523' target='_blank'>http://doi: 10.3390/md11020523.
- Tibballs J. Australian venomous jellyfish, envenomation syndromes, toxins and therapy. Toxicon. 2006; 48(7): 830-59. Available at: 10.1016/j.toxicon.2006.07.020' target='_blank'>http://doi: 10.1016/j.toxicon.2006.07.020.
- Haddad V., Silveira F.L., Migotto A.E. Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): Etiology and severity of accidents on the Brazilian Coast. Rev Inst Med Trop Sao Paulo. 2010; 52(1): 47-50. Available at: http:doi: 10.1590/S0036-46652010000100007.
- Mariottini G.L.., Pane L. Mediterranean jellyfish venoms: a review on scyphomedusae. Mar Drugs. 2010; 8 (4): 1122-52. Available at: 10.3390/md8041122' target='_blank'>http://doi: 10.3390/md8041122.
- Cegolon L., Heymann W. C., Lange J. H., Mastrangelo G. Jellyfish Stings and Their Management: A Review. Mar. Drugs. 2013; 11(2): 523-50. Available at: 10.3390/md11020523' target='_blank'>http://doi: 10.3390/md11020523.
- Wolff K., Goldsmith L.A., Katz S.I., Gilchrest B.A., Paller A.S., Leffell D.J. Fitzpatrick’s Dermatology in General Medicine. 7th. McGraw-Hill; New York, NY, USA; 2008: 2042-45.
- Loten C., Stokes B., Worsley D., Seymour J.E., Jiang S., Isbister G.K. A randomised controlled trial of hot water (45°C) immersion versus ice packs for pain relief in bluebottle stings. Med. J. Aust. 2006; 184(7): 329-33. Available at: http://doi.org/10.5694/j.1326-5377.2006.tb00265.x.
- Remigante A., Costa R., Morabito R., La Spada G., Marino A., Dossena S. Impact of Scyphozoan Venoms on Human Health and Current First Aid Options for Stings. Toxins (Basel). 2018; 10 (4): 133. Available at: 10.3390/toxins10040133' target='_blank'>http://doi: 10.3390/toxins10040133.
Supplementary files
