title: Digital ischaemia: a rare but severe complication of jellyfish sting.
abstract: We report a case of digital ischaemia in a 31-year-old man who presented with sudden hand numbness, swelling, and cyanosis 4 days after a jellyfish sting. This is a rare complication of jellyfish sting, characterised by a delayed but rapid downhill course. Despite serial monitoring with prompt fasciotomy and repeated debridement, he developed progressive ischaemia in multiple digits with gangrenous change. He subsequently underwent major reconstructive surgery and aggressive rehabilitation. Although jellyfish stings are not uncommon, no severe jellyfish envenomation has been reported in the past in Hong Kong and there has not been any consensus on the management of such injuries. This is the first local case report of jellyfish sting leading to serious hand complications. This case revealed that patients who sustain a jellyfish sting deserve particular attention to facilitate early detection of complications and implementation of therapy.
authors.affiliation: Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Stacey C
authors.initials: SC
authors.lastname: Lam
authors.affiliation: Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Y W
authors.initials: YW
authors.lastname: Hung
authors.affiliation: Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Esther C S
authors.initials: EC
authors.lastname: Chow
authors.affiliation: Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Clara W Y
authors.initials: CW
authors.lastname: Wong
authors.affiliation: Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: W L
authors.initials: WL
authors.lastname: Tse
authors.affiliation: Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: P C
authors.initials: PC
authors.lastname: Ho
mesh_terms: D000328:Adult; D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D003063:Cnidaria; D003937:Diagnosis, Differential; D005734:Gangrene / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006225:Hand / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis*; D008297:Male
keywords: Bites and stings/therapy; Ischemia