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Fulminant Hepatic Failure from a Sea Anemone Sting

Patricia J. Garcia, MD; Roland M. H. Schein, MD; and Joseph W. Burnett, MD
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From the University of Miami School of Medicine and the Department of Veterans Affairs Medical Center, Miami, Florida, and the University of Maryland School of Medicine, Baltimore, Maryland. Requests for Reprints: Patricia J. Garcia, MD, Department of Veterans Affairs Medical Center, Medical Service RF 111, N.W. 16th Street, Miami, FL 33125. Acknowledgments: The authors thank Dr. George Hensley for preparation of pathology specimens, Dr. Eugene Schiff for review of the manuscript, and Mrs. Jan Kampka and the Medical Media staff for technical assistance in the preparation of the manuscript.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;120(8):665-666. doi:10.7326/0003-4819-120-8-199404150-00007
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Coelenterate stings can produce various local and systemic reactions. We report the first known case of fulminant hepatic failure attributable to a sea anemone sting. The patient, who developed hepatic failure within 3 days of envenomation, had negative hepatitis serologic tests and no other potential hepatotoxin exposure. A biopsy of the liver showed massive hepatic necrosis. The patient's serum tested positive for IgG by enzyme-linked immunosorbent assay (ELISA) against Condylactis sp. antigen at a dilution of 1:450. We retrospectively tested serum from another man who had had transient elevations of liver function levels after a presumed coelenterate sting, and the titers to Condylactis sp. antigen were identically elevated.

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Grahic Jump Location
Figure 2.
Sea anemone (Condylactis species).

Commonly found in reefs and lagoons of south Florida, the Bahamas, and the Caribbean.

Grahic Jump Location
Grahic Jump Location
Figure 1.
Multiple denuded, hemorrhagic, superficial ulcerations subsequent to ruptured vesicles on the scapular skin.
Grahic Jump Location




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