The injuries with stonefish; toxinology, clinical presentations and treatment

The members of Scorpaenidae family، including stonefish (genus Synanceja) are among the most dangerous and venomous fishes in the word that inhibit in the tropical shallow waters. The toxinology of the venom of stonefish (genus Synanceja) showed that it is a mixture of proteins، containing several enzymes like hyaluronidase. The crude venom can produce cytolytic، hemolytic، neurotoxic and hypotensive effects in vivo. Immediate increasing intensive pain، local ischemia followed by cyanosis، edema and swelling are the local clinical presentations. Systemic manifestations are not uncommon. Hot water immersion of the injured limb، a local anesthetic agent without adrenaline، infiltrated into and around the wound، debridement of the necrotic tissue and the prescription of prophylactic antibiotic are the main therapeutic measures. The administration of antivenom may be considered.