Stingray Envenomation: Consequences of an Embedded Spine

Abstract

Rays and skates are fish with flattened, pancake-shaped bodies that frequent shallow water, where they often lie hidden under the sand. Some of the batoid species are characterized by a stinger with serrated edges, which is covered by a tegument made up of specialized cells that secrete toxins and enzymes with proteolytic activity. Stingray injuries to humans are common in warm coastal regions. In this report, we present a case of an injury due to the insertion of a barb from a Pacific cownose ray, Rhinoptera steindachneri. We assess the tissue complications due to the retention of the spine in the foot, the subsequent infection that caused tissue necrosis, and the reconstructive surgery performed. Based on previous experience, we highly recommend performing diagnostic procedures such as soft tissue radiographs and MRI to ensure the absence of the barb within the wound and thereby avoid further complications. Current textbook treatment is based on limited scientific studies, case reports, and successful clinical treatment of many victims.