Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10470
Title: Irukandji syndrome case series from Australia's Tropical Northern Territory.
Authors: Nickson, Christopher P
Waugh, Edith B
Jacups, Susan P
Currie, Bart J
Affiliation: Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Issue Date: Sep-2009
Citation: Annals of emergency medicine 2009-09; 54(3): 395-403
Abstract: We describe Irukandji syndrome (a painful hypercatecholaminergic condition caused by jellyfish envenoming) in Australia's Northern Territory. We collected prospectively a standardized data set on patients presenting to health facilities in the Northern Territory. Additional cases were identified retrospectively. Data collected included demographic, geographic, seasonal, and environmental features, as well as sting details, clinical manifestations, investigations, management, and outcomes. From 1990 to 2007, Irukandji syndrome affected 87 people. Age ranged from 1 to 51 years (64% male victims; 41% children [63% indigenous]). Activities associated with stings included snorkeling or scuba diving (35%) and swimming (29%). Stings commonly occurred in water greater than 2 m deep (63%), with fine weather (73%) and still or light breeze (70%). Seasonal variation was bimodal; peaks in May and October corresponded to prevailing offshore winds in the Darwin and Gove areas, respectively. Pain was severe (65%), with rapid onset (<30 minutes in 79%). Sting lesions (visible in 63%) were mild, and nematocysts (detected in 7 cases) had variable morphology. Systemic features were common, including hypertension and ECG abnormalities. Severe complications included troponin-level increases (2 cases) and cardiomyopathy with ventricular tachycardia (1 case), but no fatalities. Management included vinegar as first aid (66%), parenteral opioids (70%) (range 2 to 82.5 mg morphine equivalents in adults), and magnesium sulfate (3 cases). Hospital admission (49%) and aeromedical retrieval (16%) were commonplace. Irukandji syndrome in the Northern Territory was clinically consistent with previous studies but had distinct seasonal, geographic, and environmental features. Indigenous children in remote coastal communities are at risk, and there is room for improvement in prevention and management.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10470
DOI: 10.1016/j.annemergmed.2009.03.022
Type: Case Reports
Journal Article
Subjects: Acetic Acid
Adolescent
Adult
Analgesics, Opioid
Anesthetics
Animals
Antivenins
Bites and Stings
Cardiomyopathies
Child
Child, Preschool
Cnidarian Venoms
Female
First Aid
Hospitalization
Humans
Hypertension
Indicators and Reagents
Infant
Magnesium Sulfate
Male
Middle Aged
Northern Territory
Pain
Pain Management
Pain Measurement
Poisons
Prospective Studies
Retrospective Studies
Seasons
Swimming
Syndrome
Treatment Outcome
Young Adult
Scyphozoa
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