Pediatric jellyfish envenomation in the Mediterranean Sea

Glatstein, Miguel; Adir, Dikla; Galil, Bella S.; Scolnik, Dennis; Rimon, Ayelet; Pivko-Levy, Dikla; Hoyte, Christopher

doi:10.1097/mej.0000000000000479

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Analgesics (acetaminophen, non-steroidal anti-inflammatory drugs such as ibuprofen, and opiates) and topical antibiotics may help control the pain and prevent or treat infections, respectively. Antibiotics should cover Staphylococcus , Streptococcus , and microbes of marine origin, such as Vibrio [ 84 , 85 , 86 , 87 , 88 ]. Ocular stings may represent an ophthalmic emergency and have been managed successfully with topical cycloplegics, topical steroids, topical antibiotics, and topical antihistamines [ 89 ].…”

Section: Reactions To Scyphozoan Stingsmentioning

confidence: 99%

“…The patient presented with difficulties in breathing, hoarseness, itching, periorbital swelling, and facial edema and required hospitalization [ 101 ]. A recent retrospective study described systemic symptoms in children including fever, chills, tachycardia, muscle spasms, severe cellulitis, and two cases of anaphylactic reaction [ 87 ].…”

Section: Reactions To Scyphozoan Stingsmentioning

confidence: 99%

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Impact of Scyphozoan Venoms on Human Health and Current First Aid Options for Stings

Costa

Morabito

Spada

et al. 2018

Toxins

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Cnidaria include the most venomous animals of the world. Among Cnidaria, Scyphozoa (true jellyfish) are ubiquitous, abundant, and often come into accidental contact with humans and, therefore, represent a threat for public health and safety. The venom of Scyphozoa is a complex mixture of bioactive substances—including thermolabile enzymes such as phospholipases, metalloproteinases, and, possibly, pore-forming proteins—and is only partially characterized. Scyphozoan stings may lead to local and systemic reactions via toxic and immunological mechanisms; some of these reactions may represent a medical emergency. However, the adoption of safe and efficacious first aid measures for jellyfish stings is hampered by the diffusion of folk remedies, anecdotal reports, and lack of consensus in the scientific literature. Species-specific differences may hinder the identification of treatments that work for all stings. However, rinsing the sting site with vinegar (5% acetic acid) and the application of heat (hot pack/immersion in hot water) or lidocaine appear to be substantiated by evidence. Controlled clinical trials or reliable models of envenomation are warranted to confirm the efficacy and safety of these approaches and identify possible species-specific exceptions. Knowledge of the precise composition of Scyphozoa venom may open the way to molecule-oriented therapies in the future.

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Section: Reactions To Scyphozoan Stingsmentioning

confidence: 99%

Section: Reactions To Scyphozoan Stingsmentioning

confidence: 99%

Impact of Scyphozoan Venoms on Human Health and Current First Aid Options for Stings

Costa

Morabito

Spada

et al. 2018

Toxins

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“…Due to the diversity and complexity of jellyfish venom components, effective treatment of jellyfish stings is very difficult. Up to now, the treatment of jellyfish dermatitis is mainly based on the treatment of other dermatitis [7]; furthermore, acetic acid, ethanol, ammonia, and sodium bicarbonate are used for the first aid of jellyfish stings, but this has been controversial as these chemical reagents might stimulate the release of nematocysts and make the envenomations worse [8,9], and so the effectiveness of these methods is doubtful. Inflammatory symptoms of redness, swelling, and itching accompany the whole process of jellyfish stings, and so inhibiting inflammation is very important for the treatment of jellyfish stings.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory Effect of Metalloproteinase Inhibitors on Skin Cell Inflammation Induced by Jellyfish Nemopilema nomurai Nematocyst Venom

et al. 2019

Toxins

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Jellyfish envenomations result in extensive dermatological symptoms, clinically named as jellyfish dermatitis, which can seriously affect the daily activities and physical health of people. Inflammatory response accompanies the whole process of jellyfish dermatitis and the complexity of jellyfish venom components makes it difficult to treat jellyfish dermatitis symptoms effectively. Moreover, inhibiting inflammation is essential for the treatment of jellyfish stings and exploring the main components of jellyfish venom that cause inflammation is an urgent research area. In this study, the inhibitory effects of matrix metalloproteinase (MMP) inhibitors for venom-induced inflammation were explored at a cellular level. The expression of the three inflammatory factors, IL-6, TNF-α and MCP-1 in two skin cell lines, human keratinocyte cells (HaCaT) and human embryonic skin fibroblasts cells (CCC-ESF-1), at the cellular level, after treatment with the inhibitors of jellyfish Nemopilema nomurai (N. nomurai) nematocyst venom (NnNV-I), were determined. The results showed that inhibitors of MMP can significantly reduce the toxic effects of jellyfish Nemopilema nomurai nematocyst venom (NnNV) to skin cells. The expression levels of the three inflammatory factors IL-6, MCP-1, and TNF-α in the cells were also significantly decreased, indicating that MMPs in jellyfish venom are probably vital factors leading to jellyfish dermatitis. This study is beneficial in the prevention and treatment of jellyfish stings.

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“…Of these,~1% are medically relevant (142). Jellyfish stings typically trigger local or large local responses, manifesting as pain, swelling, and erythema, but are usually not life-threatening (143,144). However, severe delayed cutaneous reaction, allergy, and anaphylactic shock can occur (145)(146)(147).…”

Section: Hypersensitivity To Marine Stingsmentioning

confidence: 99%

Immunological Responses to Envenomation

et al. 2021

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Venoms are complex mixtures of toxic compounds delivered by bite or sting. In humans, the consequences of envenomation range from self-limiting to lethal. Critical host defence against envenomation comprises innate and adaptive immune strategies targeted towards venom detection, neutralisation, detoxification, and symptom resolution. In some instances, venoms mediate immune dysregulation that contributes to symptom severity. This review details the involvement of immune cell subtypes and mediators, particularly of the dermis, in host resistance and venom-induced immunopathology. We further discuss established venom-associated immunopathology, including allergy and systemic inflammation, and investigate Irukandji syndrome as a potential systemic inflammatory response. Finally, this review characterises venom-derived compounds as a source of immune modulating drugs for treatment of disease.

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Pediatric jellyfish envenomation in the Mediterranean Sea

Cited by 14 publications

References 21 publications

Impact of Scyphozoan Venoms on Human Health and Current First Aid Options for Stings

Impact of Scyphozoan Venoms on Human Health and Current First Aid Options for Stings

Inhibitory Effect of Metalloproteinase Inhibitors on Skin Cell Inflammation Induced by Jellyfish Nemopilema nomurai Nematocyst Venom

Immunological Responses to Envenomation

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