title: Stingray injury to the webspace of the foot.
abstract: Stingrays are cartilaginous fish that are related to sharks. They are one of the largest groups of venomous marine animals. Stingrays account for 750 to 2000 injuries annually. They are generally passive, reclusive creatures that only sting in self-defense. Most injuries caused by these animals are nonfatal. A stingray possesses between 1 and 4 venomous stings, which are located along the caudal spine. If a stingray injury is sustained, parts of the spine may be left in the lacerations, which prolongs exposure to venom and increases the risk of subsequent wound infection. Stingray venom is unique in its enzymatic composition and results in distinct soft tissue injury patterns. Typically, a pattern of acute inflammation occurs, with a predominantly lymphoid cellular infiltrate followed by necrosis. The environment in which stingray injuries occur presents unique bacterial flora, and subsequent wound infections require careful antibiotic selection.This article describes a case of a healthy 31-year-old woman who sustained a stingray injury to the webspace of the foot while in Costa Rica. Initial basic first aid measures were applied. However, the wound subsequently became infected, and formal irrigation and debridement were performed. The initial wound cultures grew Staphylococcus viridans. Two months postoperatively, the incision was well healed, and the patient was pain free and returned to work.
authors.affiliation: Department of Clinical Research, Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO 81657, USA. drhannahj@aol.com
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Jarvis
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Matheny
authors.forename: Thomas O
authors.initials: TO
authors.lastname: Clanton
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001733:Bites and Stings / Q000473:pathology* / Q000628:therapy; D003646:Debridement; D005260:Female; D005397:Fish Venoms / Q000506:poisoning*; D005528:Foot / Q000473:pathology* / Q000503:physiopathology; D018409:Foot Injuries / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D006801:Humans; D012860:Skates, Fish; D013203:Staphylococcal Infections / Q000150:complications / Q000473:pathology / Q000628:therapy; D013210:Staphylococcus / Q000302:isolation & purification / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005397:Fish Venoms