title: Blue-ringed octopus (Hapalochlaena sp.) envenomation of a 4-year-old boy: a case report.
abstract: BACKGROUND
  The blue-ringed octopus (Hapalochlaena sp.) is a small animal, which can inject a toxin that produces a respiratory arrest within minutes. This envenomation is a rare occurrence with very few reported outcomes in children.
  
  
  METHODS
  A 4-year-old boy was bitten by a blue-ringed octopus (Hapalochlaena sp.) whilst playing at a popular beach in Queensland, Australia. Within ten minutes of the bite, he had vomited three times, lost the ability to stand and complained of blurred vision. An ambulance was called by the time he presented to the local emergency department (20 minutes after the bite) he had acute and progressive skeletal muscle weakness. He was intubated, ventilated, and transferred to a pediatric intensive care unit for specialized supportive care. He was ventilated for a total of 17 hours with spontaneous muscular activity returning at around 15 hours from envenomation.
  
  
  CONCLUSIONS
  If not treated appropriately the bite of this small and innocuous looking animal could have lead to death within minutes.
  
  
  CONCLUSIONS
  This case report serves as a reminder of how appropriate treatment can ensure discharge from hospital with no long-term consequences. It also highlights the importance of education for beach goers and in particular parents to prevent exposure of tetrodotoxin to children.
authors.affiliation: Mater Children's Hospital, Paediatric Intensive Care, Raymond Terrace, South Brisbane, Brisbane, Australia. ecavazzoni@gmail.com
authors.forename: Elena
authors.initials: E
authors.lastname: Cavazzoni
authors.forename: Bruce
authors.initials: B
authors.lastname: Lister
authors.forename: Phillip
authors.initials: P
authors.lastname: Sargent
authors.forename: Andreas
authors.initials: A
authors.lastname: Schibler
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000150:complications* / Q000473:pathology / Q000628:therapy; D002675:Child, Preschool; D003422:Critical Care; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008978:Mollusk Venoms; D018908:Muscle Weakness / Q000209:etiology; D049831:Octopodiformes; D012121:Respiration, Artificial; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D014839:Vomiting / Q000209:etiology
chemical_list: D008978:Mollusk Venoms