October 21, 2014

Serpent starfish (Ophiolepsis sp.) Stings




Serpent starfish (Ophiolepsis sp.)




15 years old boy was brought to casualty by bystander after stung by serpent starfish at his right forearm while swimming in Lahad Datu Coastal region. He develops severe intense burning pain at the stung area. Vital signs are normal and no evidence of anaphylaxis. He was treated with hot water immersion at the temperature of 45 degree celcius for 20 minutes. However, intravenous weak opiod was given as he could not tolerate the pain. He was discharged well after three hours of observation in casualty.


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Tourniquet is un necessary first aid method and not proven to be beneficial. 

Examination of the hand showed lashes mark at the postero medial aspect of distal right forearm region associated with redness, warm and local swelling. No active bleeding noted and range of movement of wrist joint was intact








Discussion

Serpent starfish (Ophiolepsis sp.) is classified under phyllum echinoderm together with starfish, sea urchins, sea cucumbers, crinoids (sea lilies) and sand dollars. Serpent starfish use their flexible arms for locomotion and crawls across the sea floor. This five long slender, whip like arms' creature is a nocturnal detritivore.

This organism rarely causing severe anaphylaxis but the heat labile sting may cause severe pain and uneasiness to the patient.

Management for the sting includes hot water immersion temperature 43-45 degree Celsius for 20 minutes followed by 10-15 minutes rest then repeated for 2 hours. This technique is usually adequate to alleviate the pain. However, some patient may need intravenous pain killer including opiod. Although rare, patient should also be looked for sign and symptoms of anaphylaxis. Anti histsmine, steroids are not proven beneficial but may be used to treat symptoms of itchiness or urticaria. IM Adrenaline should be started if patient develops sign of anaphylaxis.




Immersion in hot water can alleviate the pain causing by this heat labile sting

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