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
bluebottle-sting

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:


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Toxicology Library

TOXINS

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Burnaby Hospital in Vancouver Emergency. Loves the misery of alpine climbing and working in austere environments. Supporter of FOAMed, toxicology, tropical medicine, sim and ultrasound

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