Box jellyfish envenomation: case report of effective lemon and oil emulsion treatment

Box jellyfish are highly venomous and numerous possible treatments for envenomation have already been reported in the published literature. The hand of a 55-year-old scuba diver was stung in the Gulf of Guinea resulting in two crops of coalescing vesicles with intense pain and lymphadenopathy. Traditional therapies such as hot water, cold packs and acetic acid were ineffective. Symptoms were rapidly relieved after the application of a lemon-oil emulsion balm. Treatments for jellyfish envenomation generally aim to either denature the jellyfish venom or prevent the discharge of the venom. Lemon-oil emulsion therapy has not yet been reported in the published literature but may be an economical and novel treatment for box jellyfish envenomation.