Case Report: Unusual Bullous Reaction to Physalia physalis Venom after Recurrent Envenomation. 2023

Kevin Yang, and Jeffrey D Klausner

Physalia physalis, often referred to colloquially as Portuguese man-of-war or bluebottle jellyfish, is a jellyfish-like organism found in tropical and subtropical areas of the Pacific, Atlantic, and Indian Oceans. Most often, envenomation by P. physalis tentacles results in painful but self-resolving epidermal stings. We report on two clinic visits of a patient who suffered from worsening reactions to recurrent P. physalis envenomation. The first clinical episode involved urticaria and severe pruritus that was worse than the pruritus the patient had experienced upon envenomation in the past. The second episode involved an unusual bullous reaction. Further study into the compounds present in P. physalis venom may help elucidate the mechanism of the present case and other abnormal reactions to envenomation. Patients and providers who care for patients at risk for recurrent stings (e.g., surfers, fishermen) should be cognizant of the potential for worsening reactions to envenomation. Further study into therapies such as oral antihistamines and Aloe vera gel may uncover additional appropriate treatments for symptomatic relief of P. physalis envenomation.

UI MeSH Term Description Entries
D008297 Male Males
D011537 Pruritus An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. Itching,Pruritis
D001733 Bites and Stings Injuries inflicted by the TEETH or poisoning caused by VENOMS of animals. Stings,Bites,Stings and Bites,Bite,Sting
D003064 Cnidarian Venoms Venoms from jellyfish; CORALS; SEA ANEMONES; etc. They contain hemo-, cardio-, dermo- , and neuro-toxic substances and probably ENZYMES. They include palytoxin, sarcophine, and anthopleurine. Chironex Venoms,Jellyfish Venoms,Nematocyst Venoms,Sea Anemone Venoms,Chironex Venom,Cnidarian Venom,Jellyfish Venom,Portuguese Man-of-War Venom,Sea Anemone Venom,Portuguese Man of War Venom,Venom, Chironex,Venom, Cnidarian,Venom, Jellyfish,Venom, Portuguese Man-of-War,Venom, Sea Anemone,Venoms, Chironex,Venoms, Cnidarian,Venoms, Jellyfish,Venoms, Nematocyst,Venoms, Sea Anemone
D005006 Ethnicity A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. Ethnic Groups,Nationality,Ethnic Group,Nationalities
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D037402 Hydrozoa A class in the phylum CNIDARIA which alternates between polyp and medusa forms during their life cycle. There are over 2700 species in five orders. Liriope tetraphylla,Physalia physalis,Portuguese Man-of-War,Hydrozoans,Physalia,Hydrozoan,Hydrozoas,Liriope tetraphyllas,Man-of-War, Portuguese,Man-of-Wars, Portuguese,Physalia physali,Physalias,Portuguese Man of War,Portuguese Man-of-Wars,physali, Physalia,tetraphyllas, Liriope

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