Frequency and gravity of human envenomations caused by marine catfish (suborder siluroidei): a clinical and epidemiological study

Progressive Ulnar Neuropathy Following a Presumed Catfish Sting

Catfish are a highly diverse group of fish comprising more than 3500 species found in both freshwater and marine ecosystems. Upon handling, they can inflict a sting, with certain species capable of inducing significant pain and injury to the affected extremity. The prevalence of aquatic activities, such as fishing by line or manual capture ("noodling"), increases the likelihood of catfish stings, making prompt identification and treatment an important aspect of managing such encounters. A case of a presumed catfish spine injury during noodling in Tallahassee, Florida, is presented. The pectoral fin penetrated the volar aspect of the patient's right hand resulting in immediate pain and numbness. Over the course of 2 weeks, the patient developed distal ulnar neuropathy with conduction block at the wrist level. Surgical exploration revealed the ulnar nerve to be grossly intact, but the area surrounding the terminal division point of the ulnar nerve in the hand displayed infiltration by fibrous tissue that entrapped the nerve and its branches. Following surgical release of the ulnar nerve and its terminal branches from the fibrous tissue, complete resolution of distal ulnar neuropathy was achieved. In this patient's case, the absence of foreign bodies and the lack of visible nerve damage suggest that the injury to the patient's hand was largely attributable to toxin-mediated proinflammatory response and fibrosis.

Hot-Water Immersion (HWI) or Ice-Pack Treatment (IPT) as First Aid for Human Envenomation by Marine Animals? Review of Literature

Envenomation by marine animals poses a significant health concern globally, affecting both local residents and tourists in coastal regions. The primary objective of this review is to critically evaluate the existing scientific literature to determine the most effective first-aid treatment for envenomations caused by marine animals, specifically whether hot-water immersion (HWI) or ice-pack treatment (IPT) provides the best immediate care. This comprehensive review covers a wide range of marine envenomations, from jellyfish stings to stingray injuries. While our focus is primarily on the efficacy of HWI and IPT, we also explore the role of cold-water treatment as a result of its relevance and similarity to ice-pack applications. In addition, we examine other treatments mentioned in the literature, such as medications or vinegar, and highlight their findings where applicable. To provide a clear and structured overview, we summarised the articles in separate tables. These tables categorise the type of research conducted, the marine species studied, the region of origin of the marine species, and the key findings of each study. Our analysis of the available evidence indicates a general consensus in the scientific community on the effectiveness of HWI or IPT for envenomation by marine animals. However, when treating those injuries, it is crucial to consider all factors since there is no universally superior treatment due to the diverse nature of marine habitats.

Pleisiomonas shigelloides bacteremia after catfish injury

This case of Pleisimonas shigelloides bacteremia resulting after a catfish barb injury highlights an unusual presentation of a common condition that requires alternative therapy for successful treatment. An otherwise healthy male in his early 40s presented to the emergency department with sepsis and rapidly spreading cellulitis shortly after a catfish injury at a freshwater lake. His broad-spectrum antibiotics were narrowed to ciprofloxacin when P. shigelloides grew from his blood culture. The case presents a unique mode of bacteremia, as usually P. shigelloides bacteremia develops in immunocompromised hosts after bowel wall translocation. The venomous nature of catfish barbs also contributed to the severity and rapidity of his presentation secondary to the local tissue effects of envenomation. With proper antibiotics and supportive care, he made a full recovery.

Envenomations caused by fish in Brazil: an evolutionary, morphological, and clinical vision of a neglected problem

Venomous fish are commonly found in Brazilian waters. The most important marine venomous fish species are stingrays (Dasyatidae, Gimnuridae, Myliobatidae, and Rhinopteridae families), catfish (Ariidae family), scorpionfish and lionfish (both Scorpaenidae family), and toadfish (Batrachoididae family). Meanwhile, Potamotrygonidae stingrays and Pimelodidae catfish are the most important venomous freshwater fish. The mechanisms of envenomation vary and involve various venomous apparatuses and glands. Despite not being highly developed, these venomous apparatuses in fish appear rudimentary, using structures such as fins and rays to inoculate toxins and rarely presenting with specialized structures. Toxins are produced by glandular tissue made up of proteinaceous cells, lacking true glands, and are positioned along the inoculation structures. However, systemic manifestations are rare. No antivenom serum has been developed for any species of American venomous fish. Brazilian venomous fish and their venoms have only recently attracted attention, leading to new studies not only addressing clinical issues in humans, but also exploring the discovery of new active substances with immense pharmacological potential.

Effective Pre-Clinical Treatment of Fish Envenoming with Polyclonal Antiserum

Envenomation by venomous fish, although not always fatal, is capable of causing damage to homeostasis by activating the inflammatory process, with the formation of edema, excruciating pain, necrosis that is difficult to heal, as well as hemodynamic and cardiorespiratory changes. Despite the wide variety of pharmacological treatments used to manage acute symptoms, none are effective in controlling envenomation. Knowing the essential role of neutralizing polyclonal antibodies in the treatment of envenoming for other species, such as snakes, this work aimed to produce a polyclonal antiserum in mice and test its ability to neutralize the main toxic effects induced by the venoms of the main venomous Brazilian fish. We found that the antiserum recognizes the main toxins present in the different venoms of Thalassophryne nattereri, Scorpaena plumieri, Potamotrygon gr. Orbignyi, and Cathorops spixii and was effective in pre-incubation trials. In an independent test, the antiserum applied immediately to the topical application of T. nattereri, P. gr orbygnyi, and C. spixii venoms completely abolished the toxic effects on the microcirculation, preventing alterations such as arteriolar contraction, slowing of blood flow in postcapillary venules, venular stasis, myofibrillar hypercontraction, and increased leukocyte rolling and adherence. The edematogenic and nociceptive activities induced by these venoms were also neutralized by the immediate application of the antiserum. Importantly, the antiserum prevented the acute inflammatory response in the lungs induced by the S. plumieri venom. The success of antiserum containing neutralizing polyclonal antibodies in controlling the toxic effects induced by different venoms offers a new strategy for the treatment of fish envenomation in Brazil.

Intraosseous Catfish Barb Treated With Cannulated Drill in a Pediatric Patient

Catfish injuries to the upper extremity following fishing activities are common in the southern United States, especially because noodling is commonplace in this region. Noodling is when a fisher will stick their hand into an area where a catfish is guarding its eggs and grab the catfish by its mouth. Different mechanisms of injury, including envenomation and spine embedment, can occur and ultimately lead to different patient presentations, including the retention of foreign bodies or infection. Literature reviews of catfish injuries primarily report the retention of foreign bodies within soft tissues, infection, and envenomation. We present the first case report of a patient who sustained a ring finger proximal phalangeal physeal injury involving the growth cartilage caused by a penetration injury from a catfish barb. A novel method for safely extracting these barbs with no subsequent growth arrest or range of motion limitation is also presented.

Compartment Syndrome and Wrist Disarticulation After a Catfish Sting

Catfish have the ability to inflict stings on their victims through spines located on their dorsal and pectoral fins. The stings of catfish can release toxins that have dermonecrotic, edemogenic, and vasospastic factors. In this case, a 56-year-old man suffered a catfish sting to his right thumb, which resulted in acute hand compartment syndrome and resultant hand fasciotomies. His hospital course was complicated by multiple irrigation and debridements, finger amputations, hand fluid cultures positive for Vibrio damsela, and eventual wrist disarticulation. The combination of envenomation, infection, and delayed presentation for treatment ultimately led to a hand amputation.

Animal Venom Peptides as a Treasure Trove for New Therapeutics Against Neurodegenerative Disorders

BACKGROUND

Neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and cerebral ischemic stroke, impose enormous socio-economic burdens on both patients and health-care systems. However, drugs targeting these diseases remain unsatisfactory, and hence there is an urgent need for the development of novel and potent drug candidates.

METHODS

Animal toxins exhibit rich diversity in both proteins and peptides, which play vital roles in biomedical drug development. As a molecular tool, animal toxin peptides have not only helped clarify many critical physiological processes but also led to the discovery of novel drugs and clinical therapeutics.

RESULTS

Recently, toxin peptides identified from venomous animals, e.g. exenatide, ziconotide, Hi1a, and PcTx1 from spider venom, have been shown to block specific ion channels, alleviate inflammation, decrease protein aggregates, regulate glutamate and neurotransmitter levels, and increase neuroprotective factors.

CONCLUSION

Thus, components of venom hold considerable capacity as drug candidates for the alleviation or reduction of neurodegeneration. This review highlights studies evaluating different animal toxins, especially peptides, as promising therapeutic tools for the treatment of different neurodegenerative diseases and disorders.

Profile of skin diseases in a community of fishermen in the northern coast of the state of São Paulo: the expected and the unusual

BACKGROUND

The fishing colony of the Picinguaba neighborhood is located at the northern end of the coast of the state of São Paulo. It has about 300 residents, of which approximately 100 are professional fishermen.

OBJECTIVES

This study aimed to identify the main dermatoses of the community in comparison with other populations, and their frequency.

METHODS

The dermatoses were identified and tabulated for two years, in a prospective study carried out on monthly trips to the fishermen's colony in Picinguaba.

RESULTS

One hundred and eighteen patients were attended and followed up, which is equivalent to about 1/3 of the colony's inhabitants. Of these, 43 were children (under the age of 14) and 75 were adolescents and adults. The diseases observed were catalogued according to the age groups. Although most dermatoses in the community were similar with those observed in the general population, some specific cases could be seen, such as folliculitis on the legs of fishermen and an unexpected low frequency of actinic lesions in the colony, as well as dermatitis by aquatic animals.

STUDY LIMITATIONS

The limitations were monthly attendance and the spontaneous demand of the patients.

CONCLUSIONS

The finding of community-specific dermatoses and the low incidence of malignant and pre-malignant tumors associated with sun exposure needs further studies for better clarification.

Recreational and Commercial Catfishing Injuries: A Review of the Literature

Catfish injuries are increasingly common from the recreational activities of hobbyists, fishermen, and "noodling" enthusiasts as well as in the commercial catfish industry, most commonly in Brazil. Injuries can range from mild skin abrasions to life-threatening infections and tissue damage requiring urgent treatment. Most injuries and subsequent morbidity associated with catfish encounters involve the dorsal and pectoral fins. These injuries are most often lacerations involving the upper extremities. Deep, penetrating catfish spine injuries can lead to serious injuries, including arterial and nerve lacerations. Catfish venom is released when a spine is torn. The venom may cause reactions that include erythema, edema, local hemorrhage, tissue necrosis, and muscle contractions. When "finned" by a catfish, the fish's spine may separate from the fish, which can cause a foreign body embedment. Some injuries are not thought to be severe enough at the time of injury to require medical care, although symptoms may arise years later. In this literature review of catfishing injuries, references were obtained through a PubMed search of the following terms: catfish injuries, fishing, envenomation, spine, and aquatic infection. Articles were chosen for citation based on pertinence to the topic of catfishing.

Freshwater Catfish Envenoming in a Tropical Country

OBJECTIVE

Freshwater catfish are known to cause painful stings in humans. Stings usually cause mild envenomation and, in some instances, can lead to severe secondary bacterial infections. Sri Lanka is a tropical country where catfish stings are not rare. However, presenting signs and symptoms, complications, and management options are scarce in the literature.

METHODS

A retrospective, descriptive, cross-sectional study was conducted by reviewing patient records in the university surgical units and surgical clinic in the teaching hospital in Anuradhapura, Sri Lanka, during 2015.

RESULTS

Ten patients presented to the hospital following catfish stings. The common presenting features following stings were severe pain, swelling, and lymphadenopathy followed by cellulitis. Late complication such as tenosynovitis were also observed.

CONCLUSIONS

Routine procedures are sufficient to reduce further complications. However, people who are at high risk of encountering catfish, and travelers visiting tropical countries, should be aware of the possibility of stings and take necessary precautions.

Diagnostic imaging of injuries caused by venomous and traumatogenic catfish

Injuries caused by fish are common in marine and freshwater environments. Catfish of the Ariidae and Pimelodidae families cause about 80% of those injuries. One of the complications of injuries caused by fish is the retention of fragments of the stinger in the wounds. Here we report five cases (of a total of 127 injuries caused by catfish in the Brazilian coast) in which the retained fragments were detected by radiological examination. Retained fragments should be considered in patients stung by catfish. A simple X-ray is sufficient to detect fragments of stingers in the wounds.

Injuries caused by the venomous catfish pintado and cachara (Pseudoplatystoma genus) in fishermen of the Pantanal region in Brazil

INTRODUCTION

the fishing activity throughout the Upper Paraguay River Basin has huge financial and biological importance. This retrospective study investigated the occurrence of injuries caused by fish of the Pseudoplatystoma genus (spotted catfish or pintado and striped catfish or cachara) in professional fishermen of the Pantanal of Mato Grosso do Sul State.

METHODS

we collected information through a questionnaire, showing that fishing is carried out by workers with low level of education, mainly adults or seniors with low financial gains.

RESULTS

in Miranda town, 126 of 315 fishermen were interviewed and 38 individuals reported injuries (30.16%). In Corumbá town, 355 of 627 fishermen were interviewed, and 111 (56,61%) reported injuries. The lacerated lesions were the most common, associate with edema, erythema, radiating pain to the root of the limb, paresthesias and local necrosis. More rarely, they reported the occurrence of fever, cardiac arrhythmias and cold sweating. These manifestations may be associated with late secondary infections or envenomations caused by the toxins in the stingers of the fish. Many questionable and inappropriate treatments are used, sometimes aggravating the injuries.

CONCLUSIONS

the freshwater professional fishermen need guidance on first aid measures and prevention of accidents caused by these venomous fish.

Heated Debates: Hot-Water Immersion or Ice Packs as First Aid for Cnidarian Envenomations?

Cnidarian envenomations are an important public health problem, responsible for more deaths than shark attacks annually. For this reason, optimization of first-aid care is essential. According to the published literature, cnidarian venoms and toxins are heat labile at temperatures safe for human application, which supports the use of hot-water immersion of the sting area(s). However, ice packs are often recommended and used by emergency personnel. After conducting a systematic review of the evidence for the use of heat or ice in the treatment of cnidarian envenomations, we conclude that the majority of studies to date support the use of hot-water immersion for pain relief and improved health outcomes.

Bioactive components in fish venoms

Animal venoms are widely recognized excellent resources for the discovery of novel drug leads and physiological tools. Most are comprised of a large number of components, of which the enzymes, small peptides, and proteins are studied for their important bioactivities. However, in spite of there being over 2000 venomous fish species, piscine venoms have been relatively underrepresented in the literature thus far. Most studies have explored whole or partially fractioned venom, revealing broad pharmacology, which includes cardiovascular, neuromuscular, cytotoxic, inflammatory, and nociceptive activities. Several large proteinaceous toxins, such as stonustoxin, verrucotoxin, and Sp-CTx, have been isolated from scorpaenoid fish. These form pores in cell membranes, resulting in cell death and creating a cascade of reactions that result in many, but not all, of the physiological symptoms observed from envenomation. Additionally, Natterins, a novel family of toxins possessing kininogenase activity have been found in toadfish venom. A variety of smaller protein toxins, as well as a small number of peptides, enzymes, and non-proteinaceous molecules have also been isolated from a range of fish venoms, but most remain poorly characterized. Many other bioactive fish venom components remain to be discovered and investigated. These represent an untapped treasure of potentially useful molecules.

Report of 15 injuries caused by lionfish (pterois volitans) in aquarists in Brazil: a critical assessment of the severity of envenomations

Lionfish are venomous fish that belong to the Scorpaenidae family. Individuals of this family and those of the Synanceiidae family comprise most of the existing venomous fish in the world. Lionfish are originally found in the Indo-Pacific, but they have received special attention in the last years for their dissemination in the Atlantic Ocean, with the emergence of large populations in the USA, Caribbean and South America. Because of its beauty, this fish has always been present in private and commercial aquariums around the world. Herein, we describe 15 envenomations in aquarists registered in a period of eighteen years (1997–2014). The stings caused excruciating pain and marked inflammation, with local erythema, edema, heat, paleness and cyanosis. In one case, it was possible to observe vesicles and blisters. There were no skin necroses or marked systemic manifestations. We discuss the possible coming of the fish to South America and the circumstances and clinical impact of the envenomations.

Thoracic vertebral osteomyelitis following catfish spine impalement

Although rare, thoracic osteomyelitis can occur when toxins from a catfish spine impalement to the hand spread via the blood. This article describes diagnosis and management of this condition in a man who required hospitalization for debilitating back pain that developed 3 weeks after the initial injury.

First report of interruption of mast cell degranulation and endothelial cells activation by anti-inflammatory drugs controlling the acute response provoked by Pseudoplatystoma fasciatum fish venom

This is the first report describing in mice the envenoming that possible to occur in humans provoked by Pseudoplatystomafasciatum and evaluated the different class of mediators involved in the inflammatory injury, identifying important targets for drugs intervention. First we demonstrate that P. fasciatum venom induces an acute inflammatory response characterized by the recruitment of immune cells into peripheral tissues choreographed by chemoattractants including lipid mediators (LTB4 and PGE2), cytokines (IL-1β and TNF-α), and chemokines (KC and MCP-1). Intravital microscopy studies showed that only high dose (60 μg) of venom promoted hemodynamic changes inducing an abundant number of thrombi of varying sizes in venules leading to transient venular stasis with reduced blood flow. We found that serotonin, leukotrine and prostaglandin are involved in edematogenic and nociceptive responses, since a selective COX-2 inhibitor, a non-specific inhibitor for cytokines and COX-2, and a non-selective 5-HT receptor antagonist were able to reduce both symptoms. In conclusion, our data show that the main symptoms of acute inflammation as pain provoked by P. fasciatum fish venom could be well managed by available drugs as COX-2 inhibitors as well dexamethasone or non-selective 5-HT receptor antagonists.

Clinical manifestations and experimental studies on the spine extract of the toadfish Porichthys porosissimus

Toadfish are fish from the family Batrachoididae that are found in marine and brackish environment around the world. Among the toadfish, Porichthys genus is very common, where Porichthys porosissimus, also called Atlantic Midshipman is found in Southwest Atlantic, from Rio de Janeiro, Brazil to eastern Argentina. There was no consensus about the classification of the genus Porichthys as venomous fish because so far there are no published studies regarding human envenomations and/or toxic activities induced in animal models. Herein, we report two conclusive envenoming in human beings caused by P porosissimus spines, with clear signs and symptoms that were very important for the development of our experimental studies. We demonstrated that the P. porosissimus spine extract, now venom, can induce nociceptive and edematogenic responses in mice as well an induction of an inflammatory response elicited by intravital microscopy and leukocyte migration. Finally, we identified in the P. porosissimus spine extract, through analysis by mass spectrometry, the presence of proteins previously detected in the venoms of other fish species and other venomous animals. We believe that based on our studies we will dismiss the non-venomous nature of this fish and clarify this issue.

Structure and possible functions of constant-frequency calls in Ariopsis seemanni (Osteichthyes, Ariidae)

In the 1970s, Tavolga conducted a series of experiments in which he found behavioral evidence that the vocalizations of the catfish species Ariopsis felis may play a role in a coarse form of echolocation. Based on his findings, he postulated a similar function for the calls of closely related catfish species. Here, we describe the physical characteristics of the predominant call-type of Ariopsis seemanni. In two behavioral experiments, we further explore whether A. seemanni uses these calls for acoustic obstacle detection by testing the hypothesis that the call-emission rate of individual fish should increase when subjects are confronted with novel objects, as it is known from other vertebrate species that use pulse-type signals to actively probe the environment. Audio-video monitoring of the fish under different obstacle conditions did not reveal a systematic increase in the number of emitted calls in the presence of novel objects or in dependence on the proximity between individual fish and different objects. These negative findings in combination with our current understanding of directional hearing in fishes (which is a prerequisite for acoustic obstacle detection) make it highly unlikely that A. seemanni uses its calls for acoustic obstacle detection. We argue that the calls are more likely to play a role in intra- or interspecific communication (e.g. in school formation or predator deterrence) and present results from a preliminary Y-maze experiment that are indicative for a positive phonotaxis of A. seemanni towards the calls of conspecifics.

Should the Critically Endangered Goliath grouper Epinephelus itajara be culled in Florida?

The Goliath grouper Epinephelus itajara has been protected in the USA since 1990. In Florida commercial and recreational fishers consider the species a top predator of fish and lobster and advocate culling the grouper population as a solution to recover declining stocks. I examined the scientific evidence for and against culling the Goliath grouper, using commercial landing data from the National Marine Fisheries Service and the Florida Fish and Wildlife Conservation Commission (1950–2010), fisheries-independent diver-based surveys from the REEF Environmental Education Foundation (1993–2007), and published dietary and morphological studies. An analysis of the commercial extinction of the Goliath grouper in Florida indicates that its recovering population is not the cause of declining fish and lobster stocks. The recovering Goliath grouper population could provide ecological and socio-economic benefits: as top-down control on other lobster predators, in ecotourism, and as potential biocontrol of the invasive Indo-Pacific red lionfish Pterois volitans on Atlantic reefs.

Specialization of the sting venom and skin mucus of Cathorops spixii reveals functional diversification of the toxins

Cathorops spixii is the most common venomous fish on the Brazilian coast. Apart from the involvement with defense against pathogens, the possible contribution of skin mucus components to the development of injuries caused by venomous fish species has not been investigated. Thus, the present study was conducted to gain a better understanding of the peptide and protein components of fish skin mucus and the sting venom from the catfish C. spixii. Our results show that sting venom and skin mucus have distinct constituents that distinguished them like structural proteins, chaperones, ion transport, carbohydrate metabolism, oxidoreductase, cell cycle and protein binding present in sting venom and like tropomyosin 3 isoform 2 and energy metabolim proteins in skin mucus. But in a group of common 13 proteins we identified and isolated a WAP65 protein. The peptide fractions caused more harmful effects, such as venular stasis, hemorrhage and changes in the arteriolar wall diameter, and the protein fractions produced a typical inflammatory process in post-capillary venules. And finally we showed for the first time the presence WAP65 in sting venom and skin mucus of C. spixii using LC/MS/MS and also we purified this protein in the sting venom. Wap65 shows inflammatory action, working at different doses inducing an increase in the number of leukocytes rolling and adhering to the endothelium.

Deep soft-tissue necrosis of the foot and ankle caused by catfish envenomation: a case report

Catfish envenomations represent a relatively rare cause of complications in podiatric medicine. We report a case of an unusual event eliciting a severe soft-tissue necrosis in a 21-year-old man and his complicated wound-healing process. This case reviews the potential complications of catfish envenomations.

Marine catfish sting causing fatal heart perforation in a fisherman

Many marine catfish have serrated bony stings ("spines"), which are used in defense against predators, on the dorsal and pectoral fins. While catfish-induced injuries are generally characterized by the pain associated with envenomation, the stings in some species are sufficiently long and sharp to cause severe penetrating trauma. Most injuries are to the hands of victims, commonly fishermen. We report the death of a fisherman caused by myocardial perforation from a catfish sting. To our knowledge, this is the first such description in the medical literature.

Analysis of the inflammatory reaction induced by the catfish (Cathorops spixii) venoms

Cathorops spixii is one of the most abundant venomous fish of the southeastern coast of the State of São Paulo, and consequently causes a great part of the accidents seen there. The accidents affect mainly fishermen, swimmers and tourists and are characterized by punctiform or wide wounds, erythema, edema, pain, sudoresis, indisposition, fever, nausea, vomiting and secondary infection. The objective of this work was to characterize the inflammatory response induced in mice by both venoms (mucus and sting) of the catfish C. spixii. Our results demonstrated that both venoms induced a great number of rolling and adherent leukocytes in the post-capillary venules of cremaster muscle of mice, and an increase in the vascular permeability in peritoneal cavity. Mucus induced the recruitment of neutrophils immediately after injection followed later by macrophage infiltration. In contrast, the cellular infiltration elicited by sting venom was rapidly resolved. The peritonitis reaction provoked by venoms was characterized by cytokine (IL-6), chemokines (MCP-1 and KC) or lipid mediator (LTB4) production in the peritoneal cavity. The macrophages from 7-day mucus venom-induced exudates upon in vitro mucus venom stimulation, expressed CD11c x MHC class II and release bioactive IL-12p70. On the other hand, sting venom-elicited peritoneal macrophages lost the ability to differentiate into dendritic cells, following re-stimulation in vitro with sting venom, they do not express CD11c, nor do they exhibit sufficient levels of MHC class II. In conclusion, both types of venoms (mucus or sting) promote inflammatory reaction with different profiles, and the inflammatory reaction induced by the first was characterized by antigen persistence in peritoneal cavity that allowed the activation of phagocytic cells with capacity of antigenic presentation.