Jellyfish stings are the most common cause of marine envenomation in humans. Various
species of box jellyfish have been identified around Penang Island, Malaysia, and
these include multitentacled and four-tentacled box jellyfish (class Cubozoa). The
typical syndrome following envenomation from these jellyfish has been poorly documented,
posing a greater challenge when managing an unidentified jellyfish sting from Penang
Island. We report a case of a 32-y-old man from Penang Island who was stung by an
unidentified jellyfish while walking into the sea. The patient reported that he felt
an immediate and severe electric current‒like pain over both thighs, left flank, and
left forearm, followed by chest discomfort and breathlessness. Vinegar was applied
over the affected areas, and he was rushed to a hospital, where he was treated with
analgesia, steroids, and antihistamine. He refused hospitalization and was discharged
against medical advice. He then presented to a noncoastal hospital 377 km away in
Kuala Lumpur on the following day with severe pain over the affected sites as well
as chest discomfort, shortness of breath, and abdominal cramps. The electrocardiograph
demonstrated features of Wolff-Parkinson-White. Serial blood test results showed elevated
creatine kinase but normal troponin I levels. The patient was managed symptomatically
over a period of 4 d and was discharged with cardiology follow-up. Appropriate health-seeking
behavior needs to be emphasized. This case report provides an opportunity to document
the signs and symptoms of envenomation from possibly an undescribed jellyfish species
near the coastal waters of Penang Island.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: March 17, 2023
Accepted:
January 24,
2023
Received:
September 1,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
