Intracerebral hemorrhage and death after envenoming by the jellyfish<i>Carukia barnesi</i>

Pereira, Peter; Barry, Jane; Corkeron, M.; Keir, Pip; Little, Mark; Seymour, Jamie

doi:10.3109/15563651003662675

Cited by 32 publications

(29 citation statements)

References 15 publications

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“…These proteins are related to box jellyfish toxins CrTX-A, CaTX-A and CqTX-A isolated from the venoms of Carybdea rastonii [16], Carybdea alata [17] and Chironex yamaguchii [18] (as Chiropsalmus quadrigatus; renamed 2009 [19]), respectively, as well as Cytotoxin A (isoforms 1 and 2) and Cytotoxin B (partial sequence), retrieved from a Malo kingi tentacle cDNA library [20] (see also [21] for disputed species identification). Using Mascot, three members of this family were identified, CfTX-1 and -2 and a homologue of CqTX-A (Table 1.…”

Section: Resultsmentioning

confidence: 99%

Venom Proteome of the Box Jellyfish Chironex fleckeri

et al. 2012

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The nematocyst is a complex intracellular structure unique to Cnidaria. When triggered to discharge, the nematocyst explosively releases a long spiny, tubule that delivers an often highly venomous mixture of components. The box jellyfish, Chironex fleckeri, produces exceptionally potent and rapid-acting venom and its stings to humans cause severe localized and systemic effects that are potentially life-threatening. In an effort to identify toxins that could be responsible for the serious health effects caused by C. fleckeri and related species, we used a proteomic approach to profile the protein components of C. fleckeri venom. Collectively, 61 proteins were identified, including toxins and proteins important for nematocyte development and nematocyst formation (nematogenesis). The most abundant toxins identified were isoforms of a taxonomically restricted family of potent cnidarian proteins. These toxins are associated with cytolytic, nociceptive, inflammatory, dermonecrotic and lethal properties and expansion of this important protein family goes some way to explaining the destructive and potentially fatal effects of C. fleckeri venom. Venom proteins and their post-translational modifications (PTMs) were further characterized using toxin-specific antibodies and phosphoprotein/glycoprotein-specific stains. Results indicated that glycosylation is a common PTM of the toxin family while a lack of cross-reactivity by toxin-specific antibodies infers there is significant divergence in structure and possibly function among family members. This study provides insight into the depth and diversity of protein toxins produced by harmful box jellyfish and represents the first description of a cubozoan jellyfish venom proteome.

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Section: Resultsmentioning

confidence: 99%

Venom Proteome of the Box Jellyfish Chironex fleckeri

et al. 2012

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“…Other taxa are also a threat. For example, ''Irukandji Syndrome'' is an envenoming reaction in humans that results from stings of several species of box jellyfish (Little et al, 2006), which on rare occasions results in death (Pereira et al, 2010). Cubozoans that pose threats to humans occur in tropical waters of many parts of the world (Fenner & Lippmann, 2009).…”

Section: Introductionmentioning

confidence: 99%

Abundance patterns of cubozoans on and near the Great Barrier Reef

2012

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The ecology of cubozoans is poorly understood and there are few quantitative studies on their distribution patterns. Sampling was designed to test first for variation in abundance with distance across the continental shelf in waters of the Great Barrier Reef, Australia. Second, we tested for the possible influence of islands versus submerged reefs on the abundances of cubozoan jellyfishes. Jellyfishes were collected after attraction to tethered night lights. Additional sampling focused on turbid near-shore waters. Carybdeid jellyfishes were found at mainland, inner, and mid-shelf reefs during summers between 2007 and 2010. No cubozoan medusae were found at outer reef sites. Copula sivickisi and Carukia barnesi were more abundant near reefs with islands than at fully submerged reefs. There was no evidence of lunar periodicity in abundance for these cubozoan taxa. Chironex fleckeri medusae were only found close to shore near the mainland, but they were rarely observed when riverine runoff was high. All taxa were characterized by high spatial and temporal variation and there was some evidence for small populations at spatial scales of less than one kilometer. ''Blooms'' and related intensity of predation and risk to humans are most likely at small spatial scales.

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“…Irukandji syndrome (IS) came to the public attention with the report of the deaths of two tourists in 2002 attributed to a small box jellyfish in tropical Queensland, Australia. Both fatalities were attributed to a hypertensive‐induced cerebral haemorrhage, stressing the importance of controlling the acute hypertensive state that can arise in some cases of this painfully debilitating marine envenomation .…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 6–18 h after the sting, patients can develop pulmonary oedema, which may be associated with depressed ejection fraction, reduced cardiac output and raised serum cardiac enzymes . The two documented fatalities attributed to IS have both been offshore stings, Great Barrier Reef and Whitsunday Islands, and both were due to intracranial haemorrhages, presumed secondary to severe hypertension . The first was a 58‐year‐old man stung in the Whitsunday Islands, who developed critical hypertension (260/160 mmHg) and had a raised troponin T (27 µg/L).…”

Section: Introductionmentioning

confidence: 99%

Review article: Role of magnesium sulphate in the management of Irukandji syndrome: A systematic review

Rathbone

Franklin

Gibbs

et al. 2016

Emerg Medicine Australasia

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Signs of Irukandji syndrome (IS) suggest an underlying catecholamine storm with research demonstrating that Carukia barnesi venom causes a significant rise in adrenaline/noradrenaline serum levels. A systematic review was undertaken to ascertain the current evidence in treating IS with magnesium salts. A literature search was conducted using Scopus, Medline and ScienceDirect. Further articles were discarded via title description and/or abstract details. The remaining were read in full, and those identified as not having sufficient information regarding magnesium and patient outcomes were removed. Nine articles were identified. One article was a randomised controlled trial, which concluded that there appears to be no beneficial difference between those patients who received the magnesium sulphate (MgSO ) and those who received the placebo and recommended against the use of MgSO in IS. Of the remaining eight, one reported the failure of MgSO and the remaining seven were case series reporting varying success in its use. This systematic review found insufficient evidence to support any clear recommendation regarding the use of magnesium, but nor was there clear evidence to recommend against its use in IS. Two case series describe significant reduction in key symptoms and hypertension but are a non-randomised albeit prospective series with the limitations accompanying this. The reporting of recrudescence of symptoms with reduction of dose does suggest a dose-response relationship. The evidence for the use of MgSO is at best anecdotal, and further research is required to either confirm its benefit or confirm the randomised controlled trial.

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Intracerebral hemorrhage and death after envenoming by the jellyfishCarukia barnesi

Abstract: This is the first case of a death because of Irukandji syndrome where the jellyfish Carukia barnesi has been demonstrated to the causative creature.

Cited by 32 publications

References 15 publications

Venom Proteome of the Box Jellyfish Chironex fleckeri

Venom Proteome of the Box Jellyfish Chironex fleckeri

Abundance patterns of cubozoans on and near the Great Barrier Reef

Review article: Role of magnesium sulphate in the management of Irukandji syndrome: A systematic review

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