Marine stingray injuries to the extremities

Abstract

Stingray injuries are usually reported from coastal regions. The injury is caused by the tail spine of the stingray, which can penetrate deep into the soft tissues, and the venom in the tail can cause extensive tissue damage. Imaging plays a very important role in patients with stingray injuries, especially to detect the presence of retained foreign bodies and its complications. We present three cases of stingray injuries to the extremities, with a special emphasis on radiographic findings. Embedded foreign bodies that were radiographically visualized were removed in two of the patients (one patient was discharged at request and was lost to follow-up). We also discuss the types of injuries, clinical presentation, importance of imaging and management considerations in stingray injuries.

Superior Optic Vein Thrombosis Related to Orbital Cellulitis Secondary to Aquatic Injury

“…Stingray strike injury sites are usually the distal lower extremity. Thoraco-abdominal stingray spine injuries are rare but can cause mortality due to cardiac complications [1]. Stingray injuries can be complicated by poor wound healing, tissue necrosis, and bacteremia.…”

“…Stingrays are cartilaginous fish that live in salt and fresh water and comprise one of the larger groups of venomous marine animals [1]. The incidence of stingray injury in freshwater is 1.7/100 [2].…”

Late Presentation of a Retained Stingray Spine in the Plantar Medial Hindfoot

“…Radiographs of the affected body part can should be obtained to rule out the presence of gas in the tissues, suggestive of bacterial infection, and for further evaluation of retained fragments. 1,15 Although multiple studies have found hyperdense, radio-opaque pieces of retained spine on plain film x-ray, fragments are not always visibly apparent as the spine itself is composed of a cartilaginous material known as vasodentin. 5,11,15 Ultrasonography can be utilized in cases with high index of suspicion for a retained foreign body despite negative radiographs, as it has been shown to be effective in identifying radiolucent objects in wounds.…”

“…1,15 Although multiple studies have found hyperdense, radio-opaque pieces of retained spine on plain film x-ray, fragments are not always visibly apparent as the spine itself is composed of a cartilaginous material known as vasodentin. 5,11,15 Ultrasonography can be utilized in cases with high index of suspicion for a retained foreign body despite negative radiographs, as it has been shown to be effective in identifying radiolucent objects in wounds. 9 MRI also has utility in cases of established infection 10 or when a retained spine is not visualized on plain radiographs, as was the situation in our case report.…”

Case Report: Iatrogenic Infection from Traditional Treatment of Stingray Envenomation

“…Culture revealed infection with Shewanella, and intravenous treatment with ceftazidime was started. 12 A known complication to wound infection after stingray attacks is necrotizing fasciitis which was diagnosed in the right tibialis anterior muscle 3 days after a 43-year-old man from Florida had been stung. The causative agent, Photobacterium damsela was sensitive to doxycyclin and cephalexin.…”