The toxicology of greater weever (Trachinus draco): Clinical and forensic aspects

Trachinus draco, also known as greater weever, is a venomous fish species that belongs to the Trachinidae family and is found in the northeastern Atlantic and Mediterranean. It is responsible for many European fish envenomations, particularly among fishermen, divers, and swimmers. This work aims to fully review the current knowledge regarding pathophysiology, symptomatology, treatment, and forensic aspects of greater weever stings. Trachinus draco venom, which is primarily delivered through spines, often results in excruciating pain, local inflammation, and in severe cases, even systemic symptoms and death may occur. The diagnosis is usually clinical but can be aided by geographical and circumstantial clues. The treatment relies primarily on hot water immersion, analgesics, and wound care to relieve pain and prevent late complications, although it is best to avoid envenomation altogether through preventive measures like the use of protective gear and cautionary behavior. With an increase in the popularity of water-related activities and tourism, a review that consolidates all relevant clinical and forensic information regarding greater weever envenomations becomes increasingly important in order to reduce the incidence of stings and envenomation complications throughout the world and to promote further research in this area.