Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
TOXRUN-Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal.
Int J Environ Res Public Health. 2022 Jul 10;19(14):8430. doi: 10.3390/ijerph19148430.
Jellyfish are ubiquitous animals registering a high and increasing number of contacts with humans in coastal areas. These encounters result in a multitude of symptoms, ranging from mild erythema to death. This work aims to review the state-of-the-art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic aspects of jellyfish stings. There are three major classes of jellyfish, causing various clinical scenarios. Most envenomations result in an erythematous lesion with morphological characteristics that may help identify the class of jellyfish responsible. In rare cases, the sting may result in delayed, persistent, or systemic symptoms. Lethal encounters have been described, but most of those cases happened in the Indo-Pacific region, where cubozoans, the deadliest jellyfish class, can be found. The diagnosis is mostly clinical but can be aided by dermoscopy, skin scrapings/sticky tape, confocal reflectance microscopy, immunological essays, among others. Treatment is currently based on preventing further envenomation, inactivating the venom, and alleviating local and systemic symptoms. However, the strategy used to achieve these effects remains under debate. Only one antivenom is currently used and covers merely one species (). Other antivenoms have been produced experimentally but were not tested on human envenomation settings. The increased number of cases, especially due to climate changes, justifies further research in the study of clinical aspects of jellyfish envenoming.
水母是无处不在的动物，在沿海地区与人类的接触越来越频繁。这些接触会导致多种症状，从轻度红斑到死亡不等。本研究旨在综述水母蜇伤的病理生理学、诊断、治疗以及相关临床和法医学方面的最新进展。水母主要有三大类，引起不同的临床情况。大多数蜇伤会导致红斑性损伤，其形态特征有助于确定负责的水母种类。在极少数情况下，蜇伤可能导致延迟、持续或全身症状。已描述过致命的遭遇，但大多数此类病例发生在印度太平洋地区，那里可以找到最致命的水母类——箱形水母。诊断主要基于临床，但可以通过皮肤镜检、皮肤刮片/粘性胶带、共聚焦反射显微镜、免疫组化等方法辅助诊断。目前的治疗方法主要是防止进一步的毒液侵害、中和毒液以及缓解局部和全身症状。然而，实现这些效果的策略仍存在争议。目前仅使用一种抗毒液，且仅涵盖一种物种（）。其他抗毒液已在实验中生产，但尚未在人类蜇伤情况下进行测试。由于气候变化等原因，病例数量的增加证明了在研究水母蜇伤的临床方面需要进一步的研究。
