Jellyfish responsible for Irukandji syndrome

Extract

Sir,

Irukandji syndrome is a distressing array of symptoms following a jellyfish sting. ¹ Generally, symptoms develop 20–60 min after the sting, and include back pain, nausea, abdominal cramps, sweating, hypertension, tachycardia and a feeling of impending doom. ^1–3 The sting usually leaves only mild local signs. In a series of 116 cases presenting to Cairns Base Hospital in one year, 64% required hospital admission and there was one death. ² Patients suffer severe pain, as demonstrated by the adult patients in this series requiring a mean dose equivalent to 42 mg of morphine. ² There have been case reports of patients developing life-threatening cardiac failure requiring intubation and inotropic support. ³ In Huynh's series, 22% had evidence of myocardial injury, with an elevated troponin. ² Reports of Irukandji syndrome have come from Australia, Hawaii, Florida, French West Indies, Bon Air, Caribbean, Timor Leste and Papua New Guinea. ¹ The syndrome may well occur in many other parts of the world, but not be recognized.