Rhabdomyolysis secondary to an accident with marine stingray (Dasyatis family)

Masson AA (1), Ormonde do Carmo PHA (1), Carvalho JLV (1)

(1) Intensive Care Unit, Aeronautics Hospital of Afonsos (HAAF), Rio de Janeiro, Rio de Janeiro State, Brazil.

Abstract: Whenever humans come in touch with the sea, they become vulnerable to risks, most frequently on account of invading a habitat that belongs to potentially harmful aquatic animals. World literature shows a growing number of incidents in recent years with marine stingrays, despite the fact that these animals only attack when harassed. This report describes an accident in which an amateur fisherman was injured by a marine stingray, probably of the Dasyatis family, on his left forearm. The puncture wound was highly painful and progressed to rhabdomyolysis. It is conjectured that lymphatic drainage, applied in an attempt to reduce edema and its complications, may have contributed to rebound increase in serum creatine kinase levels (CK) and, thus, has exacerbated the intensity of rhabdomyolysis. Therefore, as a measure of caution, lymphatic drainage should not enter current treatment protocols for similar cases, until new studies are performed in order to clarify this issue.

Key words: stingray injury, lymphatic drainage, rhabdomyolysis.

ACKNOWLEDGMENTS

We are grateful to HAAF intensive care team for their contribution during data collection.

COPYRIGHT

© CEVAP 2012

SUBMISSION STATUS

Received: February 24, 2012.

Accepted: April 2, 2012.

Abstract published online: April 5, 2012.

Full paper published online: August 31, 2012.

CONFLICTS OF INTEREST

The authors declared no conflicts of interest.

CONSENT

Written informed consent was obtained from Division of Medical Ethics and from the patient for publication of this case report and any accompanying images.

CORRESPONDENCE TO

Antonio Augusto Masson, Unidade de Terapia Intensiva, Hospital de Aeronáutica dos Afonsos (HAAF), Av. Mal. Fontenelle, 1628, Campo dos Afonsos, 21740-002, Rio de Janeiro, RJ, Brasil. Phone/fax: +55 21 3289 6700. Email: antaugmasson@gmail.com.