STRETCH: Stinging tree exposures to Cairns Hospital

Area of Science:

• Toxicology
• Dermatology
• Emergency Medicine

Background:

• Stinging tree (Dendrocnide moroides) exposure can cause severe pain and significant morbidity.
• There is a lack of clear first aid and definitive treatment guidelines for stinging tree envenomation.

Purpose of the Study:

• To evaluate the disease burden of stinging tree exposure.
• To investigate current treatments and patient responses.
• To examine the efficacy of topical dilute hydrochloric acid (HCl) for stinging tree stings.

Main Methods:

• Retrospective chart review of patients presenting to Cairns Hospital Emergency Department (ED) over three years.
• Data collected included symptoms, signs, treatments administered, and patient outcomes.
• Analysis focused on 48 cases of stinging tree exposure.

Main Results:

• All 48 patients experienced immediate pain, with 87% reporting moderate to severe pain.
• Most stings occurred on limbs (96%).
• Topical dilute HCl provided good or complete relief for nine of 29 patients treated.

Conclusions:

• Stinging tree exposure leads to substantial ED presentations annually.
• Immediate and severe pain is characteristic, with no established treatment protocols.
• Further research, including formal trials of dilute HCl, is necessary to determine optimal first aid and definitive treatments.