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My run in with Palytoxin


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#1 L8 2 RISE

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Posted 20 January 2013 - 03:27 PM

I'm sure most of you are aware of the dangers of palytoxin (one member in particular...) but I thought I'd share my experience to hopefully keep it from happening to anyone else.

Last Friday (1/11) I was moving a bunch of rock around in a tank and, as is to be expected, ended up with a bunch of cuts on my hands. One on my left index finger was particularly bad and wouldn't stop bleeding. About an hour later I was working in a tank again and picked up a rock with my left hand. I felt something squishy and my left index finger immediately began burning. I had inadvertently squished a small group of brown palythoas with my hand and the "juice" went all over my cut.

I washed it out, cleaned with alcohol, and left it for the rest of the night. Saturday morning I was woken up at 5 by a throbbing pain from my hand. My whole hand and especially the finger had swollen and the veins leading up my arm were also swollen and popping out compared to my other arm. The pain was unbearable and some of the worst I've ever felt so it was off to the ER. I told them what I thought it was (palytoxin, basically a poison from a coral) and they got me in quickly, but when the doc showed up she just treated like an infection and gave me a finger brace to protect my tendons, 800mg Motrin pills, and antibiotics and told me it should be fine within 3-4 days. If I had been thinking at the time I would have questioned it/asked more questions because there's no way it was an infection (at least not as bad as I was reacting) after just 12 hours. Fast forward to Thursday and I had a follow up with my family doctor because my finger and hand were still very swollen, I couldn't bend it all the way, and the cut seemed to be looking worse. He agreed that the antibiotics were unnecessary but had me finish them. He had me continue with Motrin (which I had stopped after about two days when the majority of the pain stopped) to help with the swelling. It's now Sunday and the finger is still swollen, but seems to be getting better. A large part of the skin around the cut on the pad of my finger has died and is peeling off but the cut itself seems to be starting to heel.

I spent some time looking around at articles online and found out Steveoutlaw really is famous! Virtually everything on palytoxin mentions his case. Here's one interesting article I found (that was started because of his case): http://www.plosone.o...al.pone.0018235.


Can’t get the full text on this, but would be interested to. It’s exactly what happened to me except he healed in 3 days: http://www.sciencedi...041010108000998

Another scary quote I found:
" His zoanthid was found to contain 2-3 milligram of palytoxin per gram.[17]For comparison, the intravenous LD50 dose of palytoxin for a grown man is less than 8 microgram. Thus each gram of the offending zoanthid contained enough venom to kill at least 125 grown men.”

Palytoxin is scary stuff, as is a lot of other things we keep in our tanks. I just wanted to remind everyone to play safe and use protection!


#2 Coral Hind

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Posted 20 January 2013 - 03:31 PM

Sorry to hear about your run in with palytoxins. There are a good bit of new members on here so this is a good reminder for them of the dangers.

#3 MBVette

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Posted 20 January 2013 - 03:33 PM

It's just that little reminder that says when we get a cut on our hands, we need to keep them out of te tank for a bit.

Glad you ok and it was nothing to major.
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#4 smallreef

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Posted 20 January 2013 - 03:35 PM

THICK vinyl cleaning gloves! I try to remember to wear them when moving rocks in my tank as I have a few groups of palys in one area...
There are so many things that can happen and unfortunently our health care system does not specialize in these and most Dr's dont know how to treat it...

#5 Orion

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Posted 20 January 2013 - 03:49 PM

I always put on gloves before I put my hands in the tank. Just never know what is on you, or what can harm you.
Glad you are doing better, OP!

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#6 Jan

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Posted 20 January 2013 - 03:52 PM

Sorry to hear about the palytoxin exposure but I'm not so sure the palytoxin caused your infection. A bacteria usually causes infection. Palytoxins cause CNS issues. Do you have a picture of the injury? It would help others so they can be aware of what to look for. Get well soon.

Palytoxins can be absorbed through the skin, without an open wound, as well as through the mucous membrane and through respiratioins via inhalation, as was the case with Steve.

Our tanks are like petri dishes. There are all kinds of bacteria and even parasites growing in them that we can contract just from the rock and water. An open wound makes it easy for them to get into our systems.

I suspect the doctor didn't see any CNS issues with you and that's why they treated with antibiotics for infection. Many infections can cause severe even constricting swelling. The symptoms will be pain, throbbing, discoloration; purple, blue, gray and red. Whereas toxin exposure will show signs of diff breathing, urticaria, general malaise, etc. Severe cases will manifest with altered mental status and severe respiratory distress.

I need to add that a "mild" sting from anemones, zoas, palys will cause localized burning, pain, redness and sometimes hives.

Edited by Jans Natural Reef Foods, 20 January 2013 - 04:29 PM.

 


#7 flooddc

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Posted 20 January 2013 - 04:57 PM

sorry to hear! get well soon.

#8 Origami

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Posted 20 January 2013 - 05:03 PM

Ouch. Sorry for the experience. Be careful, Sam. And, welcome to the club.

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#9 BaySailor

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Posted 20 January 2013 - 10:28 PM

While it may have looked like an infection, I agree there isn't any way it would have produced the kind of reaction described so quickly. And no way would I have walked out of there with a little pain killer and an antibiotic - unless I was nearly unconcious. I would have asked the doctor to look up palytoxin first. All doctors think they know all things medical and that all patients are idiots. Not that I don't like doctors or anything.

Edited by BaySailor, 20 January 2013 - 10:32 PM.


#10 sen5241b

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Posted 21 January 2013 - 02:09 AM

No pics?

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#11 Amuze

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Posted 21 January 2013 - 08:34 AM

If you did what I do for a living, you would be a lot less trusting of Dr's. Glad you're ok Sam.

#12 Jan

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Posted 21 January 2013 - 10:50 AM

Unfortunately you are right about some doctors. The best thing to do is to familiarize yourself with marine injuries and exposure. Read all you can find. You will find information under marine exposure and injuries or environmental exposures and injuries.

Print up information about palytoxin and marine stings. Bring it with you to the ER if you feel you're having a bad reaction from a sting. ER doctors are usually still learning. Many have already chosen their specialty and will go into that specialty when they finish their ER time. Many are burnt out from the hours they need to work. Be assured that they do have information available to them for specific ailments and that they will treat your "emergency"; acute difficulty breathing, anaphylactic reaction, etc.

Understand that doctors and ER staff are their to stabilize by treating the signs and syptoms; diff breathing, swelling, elevated BP, chest pain, etc.. Unless you've been bitten by something common/well known; snake, animal, spider, etc. for which there are specific protocol and sometimes antidote and you are presenting with life threating symptoms you're going to get the basic treatment. If you're in distress you will get support.

There isn't much to be done for palytoxin exposure and stings other than the standard protocol; clean wound, help prevent infection, reduce swelling, support the system and make sure vitals are stable. There's no antidote for palytoxins. The treatment is usally clean, dress wound, prescribe antibiotics and support vitals. If there is an anaphylactic reaction, which is a true emergency, you'll get treatement right away to stablize your reaction in addition to support. It is up to you to know the hazards of this hobby so you can identify when you've been exposed and are reacting to the exposure so you can advocate for yourself.

The other problem is that sometimes we don't react to these exposures right away. You can get an infection of microbactrum marinum have a few mild syptoms for a couple of days after exposure and then months later have systemic issue or isolated neuro-tendon damage. The testing is difficult for something like this. Tapeworms can enter an open wound and may take months to make you ill. You can get them from eating raw fish too. Palytoxin exposure can be mild presenting with flu like syptoms for several days or severe depending on how you react to it and how much of the toxin you've been exposed to.

The best way to take care of you is to be careful when handling rock, fish and corals. Read about what you can be exposed as well as the signs and syptoms of exposure so that you can advocate for yourself.

http://emedicine.med...089144-overview
http://www.fpnoteboo...ER/MrnInjry.htm
http://www.nlm.nih.g...icle/000032.htm
http://www.merckmanu...and_stings.html
http://www.medtogo.c...ne-animals.html

...and why do I know so much about this stuff? I was a certified senior EMT-P instructor for the FDNY for 15 years. I've taught and lectured on every topic required by all States for all pre hospital emergency care of the sick and injured.


While it may have looked like an infection, I agree there isn't any way it would have produced the kind of reaction described so quickly. And no way would I have walked out of there with a little pain killer and an antibiotic - unless I was nearly unconcious. I would have asked the doctor to look up palytoxin first. All doctors think they know all things medical and that all patients are idiots. Not that I don't like doctors or anything.


Edited by Jans Natural Reef Foods, 21 January 2013 - 11:21 AM.

 


#13 AlanM

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Posted 21 January 2013 - 11:09 AM

Does anyone have a link to some good quality gloves that you'd use to work in the tank to avoid something like this?

#14 Jan

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Posted 21 January 2013 - 11:48 AM

I bought these because of all the raw seafoods I handle when making my blends. I use them in my tank too. I turn them inside out and throw them in the wash. I paid $30.00 for mine.
http://www.tnasafety...s-Elastic-Cuffs


Does anyone have a link to some good quality gloves that you'd use to work in the tank to avoid something like this?


 


#15 steveoutlaw

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Posted 21 January 2013 - 04:05 PM

Sorry to hear Sam. I know when I went to the ER for mine, the docs had never heard of palytoxin and it was only because I brought in an article about it that they knew where to look. Jan has some good advice - print out information on it and bring it to the ER with you. Unfortunately it's just not a common enough occurrance for them to know anything.

There is no antidote for this stuff so the quicker you get it treated the better. The CDC is still contacting me about my experience because exposure to palytoxin is starting to become more prevelant.

Glad to hear it's healing!
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#16 L8 2 RISE

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Posted 21 January 2013 - 07:11 PM

Sorry to hear about the palytoxin exposure but I'm not so sure the palytoxin caused your infection. A bacteria usually causes infection. Palytoxins cause CNS issues. Do you have a picture of the injury? It would help others so they can be aware of what to look for. Get well soon.

Palytoxins can be absorbed through the skin, without an open wound, as well as through the mucous membrane and through respiratioins via inhalation, as was the case with Steve.

Our tanks are like petri dishes. There are all kinds of bacteria and even parasites growing in them that we can contract just from the rock and water. An open wound makes it easy for them to get into our systems.

I suspect the doctor didn't see any CNS issues with you and that's why they treated with antibiotics for infection. Many infections can cause severe even constricting swelling. The symptoms will be pain, throbbing, discoloration; purple, blue, gray and red. Whereas toxin exposure will show signs of diff breathing, urticaria, general malaise, etc. Severe cases will manifest with altered mental status and severe respiratory distress.

I need to add that a "mild" sting from anemones, zoas, palys will cause localized burning, pain, redness and sometimes hives.


I'm lead to believe it's palytoxin based on how fast it happened and from what I've read online (one of the articles I posted that was similar). But I suppose it may not have been.

No pics?


Sorry, I didn't take any at the time and there's not a whole lot to see now! Darn, I should have!

While it may have looked like an infection, I agree there isn't any way it would have produced the kind of reaction described so quickly. And no way would I have walked out of there with a little pain killer and an antibiotic - unless I was nearly unconcious. I would have asked the doctor to look up palytoxin first. All doctors think they know all things medical and that all patients are idiots. Not that I don't like doctors or anything.


Yeah, lesson learned, I'll make sure to be more proactive next time!


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