Jellyfish envenomation syndromes.

Jellyfish venoms are complex mixtures of polypeptides and enzymes pathogenic to man by means of their toxic or antigenic properties. With newer technology, more therapeutic agents will become available to treat the various envenomation syndromes caused by these animals. It will therefore be necessary to make an accurate diagnosis of the type of reaction the patient experiences, as well as to identify the offending species. Fatal reactions can be caused by hypersensitivity or induced by various toxins on the heart, respiratory center, or kidney. Cutaneous eruptions may be local or generalized, have exaggerated local edema, become recurrent, be delayed and persistent, or occur at sites distant from the primary sting. Fat atrophy, pigmentary changes, and contractures with gangrene can also appear. Identification of the responsible coelenterate can be made directly by actual visualization or indirectly by the knowledge of location, time, and environmental circumstances of the stinging. First-aid measures designed to prevent additional nematocyst rupture appear to be species-specific. Anaphylaxis should be counteracted by the lifesaving measures required. Other syndromes, either caused by toxic effects of the venom or mediated by humoral or cellular immune mechanisms, should be treated by means designed to interfere with their pathogenesis.