Suspected Stonefish Envenomation in Reunion Island: 15 Years Later

IntroductionAlthough marine envenomations are a reason for consultation in tropical emergency departments, stonefish stings are particularly feared. Immediate management focuses on pain control, whereas late management addresses cutaneous complications. This study presents a new series and compares the management of these patients and their outcomes at our center over the past 20 years.MethodsThis study presents a new series of 53 patients treated between 2016 and 2020 at the South Hospital of the University Hospital Center of Réunion following a sting attributed to the stonefish. We compared this new series with a previous series of patients treated at the same center for the same reason between 2001 and 2005.ResultsThe series are comparable. Regarding early management, the use of regional anesthesia was more frequent (47 vs 3.5%). Half the patients received a strong opioid. Prescription of nonsteroidal anti-inflammatory drugs and corticosteroids persisted. Exposure to a heat source remained common. Prophylactic antibiotics were prescribed more frequently (64 vs 35%) and more uniformly with amoxicillin/clavulanate. Regarding late management, the average duration of hospitalization decreased (1.8 vs 2.6 d). Cutaneous complications were less frequent (9 vs 25%). No patient managed with regional anesthesia presented cutaneous complications.ConclusionsThe management of patients in Réunion following Scorpaenidae stings has evolved over time. Regional anesthesia has become more widespread, and the prescription of probabilistic preventive antibiotic therapy is more homogeneous. These changes are associated with a shorter hospital stay and fewer cutaneous complications.