title: Dangerous reef aquaristics: Palytoxin of a brown encrusting anemone causes toxic corneal reactions.
abstract: Although frequently observed in domestic saltwater aquariums, literature on exposure to palytoxin (PTX) of encrusting anemones (Zoanthidea) kept in aquariums is rare. Handling these animals for propagation purposes or during cleaning work can lead to dermal, ocular or respiratory contact with the PTX generated by some Zoanthids. The present study describes a case of ocular exposure to liquid from a Zoanthid, which led to corneal ulcers. The patient also suffered from systemic symptoms of dyspnea and shivering and a suspected rhabdomyolysis, which required monitoring in the Intensive Care Unit. After symptomatic treatment provided insufficient results, the corneal ulcers improved with an amniotic membrane transplantation. A review of the literature regarding ocular exposures to this diverse order of Hexacorallia reveals that severe and systemic symptoms can develop with minimal contact.
authors.affiliation: Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Ruiz
authors.affiliation: National Poisons Center, Associated Institute of The University of Zurich, Zurich, Switzerland.
authors.forename: Joan
authors.initials: J
authors.lastname: Fuchs
authors.affiliation: Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland.
authors.forename: Ralf
authors.initials: R
authors.lastname: Beuschel
authors.affiliation: Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland; Department of Ophthalmology, University Hospital of Bern, Inselspital, Bern, Switzerland. Electronic address: markus.tschopp@windowslive.com.
authors.forename: Markus
authors.initials: M
authors.lastname: Tschopp
authors.affiliation: Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Goldblum
mesh_terms: D000178:Acrylamides / Q000737:chemistry / Q000302:isolation & purification / Q000633:toxicity*; D000818:Animals; D037421:Anthozoa; D001733:Bites and Stings / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D003064:Cnidarian Venoms / Q000737:chemistry / Q000633:toxicity*; D006801:Humans; D007634:Keratitis / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000139:chemically induced; D016378:Tissue Transplantation; D000095702:Polyether Toxins
chemical_list: D000178:Acrylamides; D003064:Cnidarian Venoms; C010272:palytoxin; D000095702:Polyether Toxins
keywords: Amniotic membrane transplantation; Aquarium; Corneal ulcer; Palytoxin