With the surge in the human coastal population and the increasing frequency of human activities along the coast, cases of marine envenomation, particularly jellyfish envenomation, have notably risen. Jellyfish stings can induce a spectrum of symptoms that vary in severity, encompassing skin injuries, acute systemic venom effects, delayed indirect sequelae, and even fatality, causing significant distress to patients. Among these manifestations, the occurrence of skin lesions following jellyfish stings is prevalent and substantial. These lesions are characterized by evident blister formation, development of bullae, subcutaneous hemorrhage, erythema, papules, wheal, ecchymosis, and ulceration or skin necrosis. Local cutaneous manifestations may persist for several weeks or even months after the initial sting. Despite aggressive treatment, many skin injuries still result in significant pigmentation or scarring after recovery. To address this issue effectively, it is imperative to conduct comprehensive evidence-based medical research, elucidate various components within jellyfish venom, and elucidate its pathogenic mechanism to develop targeted treatment programs. This article aims to review the skin symptoms, pathophysiology, and management of jellyfish stings. Such considerations can provide comprehensive guidance to medical professionals and the public and minimize the harm caused by jellyfish stings.

Jellyfish stings, as one of the most prevalent forms of marine injury, have increasingly become a subject of concern. Despite their simple morphology and structure, jellyfish possess a complex venom composition that can inflict varying degrees of damage on multiple human physiological systems. Consequently, the clinical symptoms associated with jellyfish stings are highly intricate. Although antivenoms have been developed for certain jellyfish species (e.g., <i>C. fleckeri</i>), specific antivenoms targeting the mechanisms of most jellyfish venoms remain understudied. To effectively prevent, treat, and cure jellyfish stings, we adhere to the principle of knowing their nature and their reasons. It is essential to investigate the emission mechanism of jellyfish nematocysts and the composition of their venom. Understanding these factors is crucial for the development of targeted treatment strategies. This review delves into the venom emission mechanism of jellyfish stinging cells, the symptoms resulting from jellyfish stings, and the comprehensive treatment strategies post-sting. It offers a scientific reference for comprehending jellyfish stings and establishes a theoretical foundation for subsequent research endeavors.

The relative lack of marine venom pharmaceuticals can be anecdotally attributed to difficulties in working with venomous marine animals, including how to maintain venom bioactivity during extraction and purification. The primary aim of this systematic literature review was to examine the key factors for consideration when extracting and purifying jellyfish venom toxins to maximise their effectiveness in bioassays towards the characterisation of a single toxin.An up-to-date database of 119 peer-reviewed research articles was established for all purified and semi-purified venoms across all jellyfish, including their level of purification, LD50, and the types of experimental toxicity bioassay used (e.g., whole animal and cell lines). We report that, of the toxins successfully purified across all jellyfish, the class Cubozoa (i.e., <i>Chironex fleckeri</i> and <i>Carybdea rastoni</i>) was most highly represented, followed by Scyphozoa and Hydrozoa. We outline the best practices for maintaining jellyfish venom bioactivity, including strict thermal management, using the "autolysis" extraction method and two-step liquid chromatography purification involving size exclusion chromatography. To date, the box jellyfish <i>C. fleckeri</i> has been the most effective jellyfish venom model with the most referenced extraction methods and the most isolated toxins, including CfTX-A/B. In summary, this review can be used as a resource for the efficient extraction, purification, and identification of jellyfish venom toxins.

Jellyfish stings represent a significant global marine hazard, causing injuries from localized skin damage to fatal systemic complications. While skin reactions are the most common symptom, heart toxicity (cardiotoxicity) is the primary cause of death. A growing body of evidence shows that the immune system’s response worsens this venom-induced heart damage. However, current research remains disproportionately focused on cutaneous inflammatory responses, leaving systemic immunopathological processes—especially those potentiating cardiotoxicity—poorly understood. Moreover, few jellyfish toxins (like those from the Chironex fleckeri) have been thoroughly studied, and the molecular mechanisms of heart injury remain largely unknown. This review introduces a novel pathophysiological classification of jellyfish envenomation into three distinct categories—immunotoxicity-dominant, cardiotoxicity-dominant, and dual-mechanism synergistic—based on clinical and mechanistic profiles. By synthesizing current knowledge on venom components and their multi-system interaction, we aim to identify actionable therapeutic targets and propose mechanism-driven treatment strategies. This refined classification offers a foundation for future clinical decision-making and the development of targeted therapies, potentially improving patient outcomes through more personalized envenomation management.

Tako-tsubo cardiomyopathy (TTC) is a transient left ventricular dysfunction, normally triggered by emotional or physical stress, although it is also associated with to use of drugs, drug abuse, or some intoxications. In addition, TTC has been reported in some case reports derived from the exposure of patients to animal venoms, toxins or poisons, or bacterial infections. However, to date, a systematic assessment of TTC in clinical toxinology is lacking. Therefore the aim of this study was to collect and integrate the available information about TTC in clinical toxinology. After our search strategy, 19 articles were retrieved, resulting in 20 case reports. Most cases occurred in women (75.0%). The venomous species that trigger TTC are bee/wasp, including probable Africanized honey bee and Vespa orientalis (15.0%), scorpions (Tytius serrulatus and Androctonus australis, 15.0%), a spider (Latrodectus tredecimguttatus, 5.0%), snakes (Gloydius blomhofii and Naja nivea, 10.0%), Clostridium sp (C. tetani, C. botulinum and C. difficile, 45.0%) and jellyfish (Pelagia noctiluca and Carukia barnesi, 10.0%). Among the affected people there were two deaths. In all case reports authors diagnosed TTC by using the combination of some of the following strategies: clinical findings, echocardiography, magnetic cardiac resonance, electrocardiogram changes and/or the increased plasma levels of cardiac damage biomarkers. In most cases images were available. We hypothesized the possible mode of action of venoms, toxins or poisons to induce TTC, however other mechanisms may exist, but they have not been described yet. Therefore, further studies are needed. In some cases, venoms, toxins, or poisons might cause catecholamine discharge either directly or indirectly, therefore, this was suggested as the trigger of TTC. Finally, the appearance of TTC should be considered in clinical toxinology.

Over 100 lineages of animal have evolved venom for a wide variety of purposes. An estimated 2.5 million people are bitten by snakes and another 1.2 million are stung by scorpions with many envenomings resulting in death. However, survival is not the end point of the envenoming syndrome as chronic life altering conditions, such as amputations, disfigurement and neuropathies can occur. In this context, infections at the site of envenomation could play an important role as they can exacerbate mortality and the incidence and severity of life altering conditions. This review assesses the connection between envenoming and infections. It summarises and highlights the literature describing cases of envenoming-mediated infection by various taxa and the circumstances of these envenomings and the outcomes of infection. It could be deduced that the risk factors for envenoming-led infections are multifactorial. Factors enhancing the risk of infection include; 1. The delivery system, with larger devices leading to more substantial wounds, 2. Venom composition, with venoms containing cytotoxins more commonly implicated in infections, and 3. The environment, with aquatic microbiomes and venom system microbiomes as sources of the pathogen species. Infections are difficult to diagnose due to symptoms synonymous with those of the envenoming and it is recommended that medical practitioners consider the possibility of infection throughout all stages of medical treatment. There is a notable gap in our understanding of envenoming-led infections and further research will help to increase patient survival.

Recurrent eruptions following unusual solitary coelenterate envenomations. The case history of four patients is presented. The first patient exhibited normal immunologic reactions to large artificial intradermal challenge with jellyfish venom and later, multiple small natural stings. The second patient, presumably envenomated by a jellyfish, had four recurrent cutaneous eruptions in a linear configuration at the same anatomic site. Because her primary coelenterate contact occurred at a time when she was receiving systemic corticosteroids, it is assumed that the eruption due to the initial sting was delayed. The third and fourth patients exhibited recurrent eruptions after solitary envenomations by different coelenterates. These case histories demonstrate that multiple recurrent eruptions may follow solitary envenomations by different subphyla of coelenterates, that the initial eruption induced by the sting may be delayed by the administration of high doses of systemic corticosteroids, and that an immunologic reaction in both the B and T cell systems can follow jellyfish envenomation. Published in Journal of the American Academy of Dermatology (1987)

Jellyfish envenomation typically causes localized pain and systemic reactions, but rare complications such as acute urinary retention and paralytic ileus can occur. We report a case of a 21-year-old fisherman from northern Sri Lanka who developed urinary retention and paralytic ileus following a jellyfish sting. He initially experienced severe pain and itching, followed by acute urinary retention, progressive abdominal distension, vomiting, and absent bowel opening. Imaging confirmed paralytic ileus without mechanical obstruction. The patient was managed conservatively with catheterization, bowel rest, intravenous fluids, analgesia, and nasogastric decompression, leading to full recovery within 48 hours. Although the exact mechanism remains unclear, previous studies have hypothesized that jellyfish neurotoxins may affect autonomic regulation. This study highlights the need for awareness of rare urological and gastrointestinal complications following jellyfish stings and emphasizes the importance of timely supportive management.

An ocular jellyfish sting is an ophthalmic emergency and is rarely reported in the medical literature. With the evolution of aquatic activities and entertainment in recent decades, we anticipate that more patients with ocular jellyfish stings may be taken to the emergency department. However, most physicians are unaware of the typical presentations, suitable treatments, prognosis, and possible complications of ocular jellyfish stings. We reported 2 cases with ocular jellyfish stings and collected cases series from literature review. The most common clinical features of ocular jellyfish stings were pain, conjunctival injection, corneal lesion, and photophobia. All patients who sustained ocular stings did so during aquatic activities, and the best management at the scene was proper analgesics and copious irrigation of affected eyes with seawater or saline. The ocular lesions were treated with topical cycloplegics, topical steroids, topical antibiotics, topical antihistamines, and removal of nematocysts. The prognosis was good, and all patients recovered without any permanent sequelae. However, symptoms in some patients may last longer than 1 week. Reported complications included iritis, increased intraocular pressures, mydriasis, decreased accommodation, and peripheral anterior synechiae.

A large number of humans are stung by jellyfish all over the world. The stings cause acute pain followed by persistent pain and local inflammation. Harmful jellyfish species typically cause strong pain, whereas harmless jellyfish cause subtle or no pain. Jellyfish sting humans by injecting a tubule, contained in the nematocyst, the stinging organ of jellyfish. The tubule penetrates into the skin leading to venom injection. The detailed morphology of the nematocyst tubule and molecular structure of the venom in the nematocyst has been reported; however, the mechanism responsible for the differe

Jellyfish Jellyfish are animals of the phylum Cnidaria. They are a monophyletic clade, the Medusozoa.[1] Most of them live in the oceans, in salt water. They eat small sea animals like plankton and little fish, and float in the sea. Only a few jellyfish live in fresh water. They have soft bodies and long, stinging, venomous tentacles that they use to catch their prey. They usually eat small plankton or small crustaceans or tiny fish. Some jellyfish hunt others by stinging cells called nematocysts. A jellyfish is 97% water.[2][3] Most jellyfish have a bell-shaped body and long tentacles at the underside of the body. Tentacles are long "arms" with special stinging cells called cnidoblasts containing the structure of the nematocyst inside. The nematocysts are pockets in the tentacle that have a small stinger that is sealed with a cap. There is a microscopic hair, or “trigger” on the outside of the pockets and when the tentacle brushes against something it activates the hair which opens the cap and allows salt water to pour in.

There is a higher incidence of the so-called summer ailments, such as jellyfish stings, skin and respiratory allergies, salmonellosis, skin cancer and others, during the hottest summers.