Human contact with venomous marine creatures is common, with serious harm resulting from biological toxins or mechanical injury inflicted by the stinging apparatus. Envenomation occurs from both vertebrate and invertebrate animals. Venomous invertebrates include the phylum Cnidaria (jellyfish, anemones), Mollusca (snails, octopods), and Echinodermata (sea stars, sea urchins). Sea snakes and spiny fish are the common venomous vertebrates.
Our knowledge of the pathophysiology related to clinical syndromes in humans and the optimal therapies for human envenomation remain limited. Evidence for effective treatment is primarily derived from in vitro and in vivo animal research with few randomized controlled human trials. However, current research in toxinology coupled with clinical observations allows the development of cogent treatment guidelines for victims of marine envenomation.
The phylum Cnidaria (formerly Coelenterata) originated in the Ediacaran period more than 750 million years ago and includes more than 9,000 species, of which approximately 100 are known to injure humans. Commonly referred to as jellyfish, they are the oldest lineage of venomous animals; however, their phylogenetic designations separate “true jellyfish” and other organisms into distinct classes (Table 116–1; Fig. 116–1A, B).
TABLE 116–1Characteristics of Common Cnidaria |Favorite Table|Download (.pdf) TABLE 116–1 Characteristics of Common Cnidaria
|Latin Name ||Common Name ||Common Habitat (Coastal Waters) |
|Cubozoa class || || |
| Chironex fleckeria ||Sea wasp ||Tropical Pacific Ocean, Indian Ocean, Gulf of Oman |
| Carukia barnesia ||Irukandji jellyfish ||North Australian |
| Chiropsalmus sppa ||Sea wasp or fire medusa ||North Australian, Philippines, Japan, Indian Ocean, Gulf of Mexico, Caribbean |
| Chiropsalmus quadrigatus ||Box jellyfish || |
| Chiropsalmus quadrumanus ||Box jellyfish || |
| Carybdea alata ||Hawaiian box jellyfish ||Hawaii |
| Carybdea rastoni ||Jimble ||Australia |
|Hydrozoa class || || |
| Physalia physalisa ||Portuguese man-of-war ||Eastern US from Florida to North Carolina, Gulf of Mexico, Australia (rare reports) |
| Physalia utriculus ||Bluebottle ||Tropical Pacific Ocean, particularly Australia |
| Millepora alcicornis ||Fire coral ||Widespread in tropical waters, including Caribbean |
|Scyphozoa class || || |
| Chrysaora quinquecirrha ||Sea nettle ||Chesapeake Bay, widely distributed in temperate and tropical waters |
| Stomolophus meleagris ||Cabbage head or cannonball jellyfish ||Gulf of Mexico, Caribbean |
| Stomolophus nomuraia ||Lion’s mane ||Yellow Sea between China and South Korea |
| Cyanea capillata ||Lion’s mane or hair jellyfish ||Northwest US to Arctic Sea, Norway and Great Britain, Australia |
| Pelagia noctiluca ||Mauve stinger or purple-striped jellyfish ||Wide distribution in tropical zones |
| Linuche unguiculata ||Thimble jellyfish ||Florida, Mexico, and Caribbean |
|Anthozoab class || || |
| Anemonia sulcata ||European stinging anemone ||Eastern Atlantic, Mediterranean, Adriatic Sea |
| Actinodendron plumosum ||Hell’s fire anemone ||South Pacific |
| Actinia equina ||Beadlet anemone ||Great Britain, Ireland |
(A) North Atlantic Portuguese man-of-war Physalia physalis with multiple tentacles dangling in the water. The tentacles filled with venomous nematocysts ...