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Marine Envenomation, Emergency Medicine

Reviewed 06/2017



Marine envenomation refers to poisoning caused by sting or bite from a vertebrate or invertebrate marine species. 


  • Sponges:

    • Contain sharp spicules with irritants that cause pru...


Signs and Symptoms

  • Sponges:

    • Itching and burning a few hours after contact

    • Local joint swelling and soft tissue edema

    • Fever

    • Malaise

    • Dizziness

    • Nausea

    • Muscle cramps

    • In severe cases, desquamation in 10 d...



  • Remove victim from water source.

  • Control airway, breathing.

  • Control hemorrhage.

  • Detoxify venom with proper wound irrigation as discussed below.

Initial Stabilization/Therapy

  • Airway, b...



Admission Criteria

Significant signs of systemic involvement or need for antivenom administration 

Discharge Criteria

No signs of systemic illness after 8 hr of observation 

Issues for Referral

Pearls and Pitfalls

  • Most toxins are detoxified with either temperature change (hot water) or pH alteration (more acidic).

  • Specific antivenoms for box jellyfish, stone fish, and sea snake envenomations ...

Additional Reading

  • Avelino-Silva  VI, Avelino-Silva  T. Images in clinical medicine. Evolution of a jellyfish sting. N Eng J Med.  2011;365(3):251.

  • Balhara  KS, Stolbach  A. Marine envenomations. ...



  • 692.89 Contact dermatitis and other eczema due to other specified agents

  • 989.5 Toxic effect of venom


  • T63.511A Toxic effect of contact with stingray, accidental (unintentional), initial en...

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