FEATURES OF THERAPY FOR ACUTE POISONING WITH JELLYFISH POISON (CLINICAL OBSERVATION)

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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 Federation

V. 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 Federation

L. 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 Federation

M. 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 Federation

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Copyright (c) 2020 Shilov V.V., Lukin V.A., Pivovarova L.P., Gromov M.I.



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