Scorpion fish sting

Definition

Scorpion fish are members of the family Scorpaenidae, which includes zebrafish, lionfish, and stonefish. These fish are very good at hiding in their surroundings. The fins of these prickly fish carry toxic venom. This article describes the effects of a sting from such a fish.

This article is for information only. DO NOT use it to treat or manage a sting from one of these fishes. If you or someone you are with is stung, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Scorpion fish venom is toxic and contains many chemicals including neurotoxins.

Where Found

Scorpion fish live in tropical waters, including along warm coasts of the United States. They are also found in aquariums worldwide.

Symptoms

A scorpion fish sting causes intense pain and swelling at the site of the sting. Swelling can spread and affect an entire arm or leg within minutes.

Below are symptoms of a scorpion fish sting in different parts of the body.

AIRWAYS AND LUNGS

  • Difficulty breathing

HEART AND BLOOD

  • Collapse (shock)
  • Low blood pressure and weakness
  • Irregular heartbeat

SKIN

  • Bleeding.
  • Lighter color of the area around the site of the sting.
  • Severe pain at the site of the sting. Pain can quickly spread to the entire limb.
  • Skin color changes as the amount of oxygen supplying the area decreases.

STOMACH AND INTESTINES

  • Abdominal pain
  • Diarrhea
  • Nausea and vomiting

NERVOUS SYSTEM

  • Anxiety
  • Delirium (agitation and confusion)
  • Fainting
  • Fever (from infection)
  • Headache
  • Muscle twitching
  • Numbness and tingling spreading out from the site of the sting
  • Paralysis
  • Seizures
  • Tremors (shaking)

Home Care

Seek medical help right away. Contact local emergency services.

FIRST AID STEPS

  • Immediately get out of the water and into a safe environment and wash the area with salt water.
  • Next soak the wound with hot water. The water should be around 100°F to 113°F (40°C to 45°C) or as hot as can be comfortably tolerated. Soak for 30 to 90 minutes, periodically checking to make sure the water is still warm. Soaking in hot water helps to inactivate the venom and relieve pain.
  • After soaking, gently wash the wound with mild soap and clean water to remove any dirt, debris, or venom that may be present.

Before Calling Emergency

Have this information ready:

  • Person's age, weight, and condition
  • Time of the sting
  • Type of fish if known
  • Location of the sting

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound will be soaked in a cleaning solution and any remaining foreign material will be removed. Symptoms will be treated. Some or all of these procedures may be performed:

  • Blood and urine tests
  • Breathing support, including oxygen, tube through the mouth into the throat, and breathing machine (ventilator)
  • ECG (electrocardiogram, or heart tracing)
  • Fluids through a vein (by IV)
  • Medicine, called antiserum, to reverse the effect of the venom
  • Medicine to treat symptoms
  • X-rays

Outlook (Prognosis)

Recovery usually takes about 24 to 48 hours. Outcome often depends on how much venom entered the body, the location of the sting, and how soon treatment is received. Numbness or tingling may last for several weeks after the sting. Skin breakdown is sometimes severe enough to need surgery.

A puncture to the person's chest or abdomen may lead to death.

References

Auerbach PS, Ditullio AE. Envenomation by aquatic vertebrates. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 75.

Curtis AM, Erickson TB. Venomous animal injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 53.

Thornton S, Clark RF. Marine food-borne poisoning, envenomation, and traumatic injuries. In: Adams JG, ed. Emergency Medicine: Clinical Essentials. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 142.

Warrell DA. Animals hazardous to humans: venomous bites and stings and envenoming. In: Ryan ET, Hill DR, Solomon T, Aronson NE, Endy TP, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2020:chap 137.

Review Date: 7/1/2023
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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