Bluebottle Jellyfish

Bluebottle Jellyfish are not actually a single organism but are made up of zooids. These bluebottles cause thousands of stings each year on Australian beaches and hot water usually provides relief. Major systemic envenoming does not occur (unlike other Physalia stings in other parts of the world).

Resus

• Not life threatening

Risk Assessment

Typical symptoms include:

• Burning pain lasting up to two hours with linear and elliptical erythematous welts.
• Systemic symptoms can rarely occur including nausea, headache and malaise

Case 1

Case 2

Supportive Care

• Hot water Place affected area in a shower or a bowl of hot water – approx 45 degrees, should be hot but not scalding or uncomfortable for 20 minutes. Previously ice packs were used but hot water has shown superiority.
• Analgesia Simple analgesia such as paracetamol and ibuprofen.
• Vinegar has been known to worsen these stings.

Investigations

• Not required

Differential Diagnosis:

• Irukandji syndrome has delayed pain and is usually severe with systemic features. Skin markings or welts are usually not seen
• Box jellyfish have immediate severe pain and obvious dermal markings and tentacles may still be adhered to the skin

Antivenom

• Not available

Disposition

• As a general rule patients do not usually require a hospital admission unless pain is an issue.

References

• Tox Library – Blue Bottle Jellyfish
• Loten C, Stokes B, Wortley D et al. A randomised controlled trial of hot water (45ºC) immersion versus ice packs for pain relief in bluebottle stings. Medical Journal of Australia 2006; 184(7):329-333
• Tibballs J. Australian venomous jellyfish, envenomation syndromes, toxins and therapy. Toxicon. 2006 Dec 1;48(7):830-59.