ORAL INTOXICATION due to the consumption of poisonous animals or their roe

Poisonous animals have toxins located in their skin, musculature, viscera or body fluids. They do not possess an apparatus with which to inject these toxins, and the toxins can only enter via the gastrointestinal tract following consumption of the poisonous animal. These animals are chiefly marine creatures, in particular fish and shellfish. Microbial food poisoning, e.g. botulism, is not covered in this guide, as this is caused by toxic substances that may develop due to incorrect preservation of food, and is not specific to animal foodstuffs.

• Poisonous animals: Diagnosis & Treatment, Biomedical database

PARENTERAL INTOXICATION caused by an external injury (puncture wound, bite, sting or a similar injury) by a venomous animal

Venomous animals, see below under point 2.

WHERE did the accident occur?

• In the water or on the water's edge: see below under point 3.
• On land: see below under point 4.

In the case of accidents caused by animals in FRESHWATER, there are the following possibilities:

• Painful puncture wounds from fish 

    Diagnosis & Treatment
    Biomedical database
    For more precise identification of the relevant animal, see Table 3.1

• Painful wounds caused by platypuses (only eastern regions of mainland Australia and Tasmania)
  Biomedical database
  

• Barely noticeable bites from sea snakes (in river mouths and further upstream in the Indo-Pacific region as well as in Lake Taal on Luzon, in the Philippines, and Lake Tegano on Rennell Island, in the Solomon Islands)
  Diagnosis & Treatment
  Biomedical database
  For more precise identification of the relevant animal, see Table 3.1

N.B. Terrestrial venomous snakes are sometimes found in freshwater. However, only rarely do bites occur in the water.

For accidents occurring in the MARINE ENVIRONMENT (seawater, brackish water and adjacent shore regions), the following two forms of venom application can be distinguished:

• Venom application to an area of skin caused by animals that have a number of microscopically small venom apparatuses distributed over their body surface or in the tissue. Following contact there are usually visible and painful changes to the affected area of skin, in the form of blotches, welts, abrasions and the like.
  Possible causes are: sponges, cnidarians, sea cucumbers and bristle worms. For more precise identification of the relevant animal, see Table 3.1.

• Localised/punctate venom application by teeth, spines and the like. The consequent bite or puncture wounds can sometimes be barely noticeable or visible! Possible causes are: sea snakes, cone shells, the blue-ringed octopus, bristle worms, sea urchins, starfish or venomous fish. For more precise identification of the relevant animal, see Table 3.1.

In order to identify the cause of an accident on land, the minimum requirement is that the patient saw the animal in question. If this was not the case, identification is difficult. Considering the large number of different types of venomous animals, bite or puncture marks are not sufficiently specific as a basis on which to make a satisfactory classification. However, some venomous animals can be excluded on the basis of geographical or clinical criteria or the circumstances of envenoming.

A rough description of the animal by the patient should be sufficient to distinguish between the two main animal categories in which medically relevant venomous animals occur.

Arthropods

They possess a more or less hard-shelled external skeleton of chitin, 3 or more pairs of legs and a segmented body with or without wings.

Venomous members of this group are scorpions, spiders, centipedes and some insects and ticks.

For more precise identification of the relevant animal, see Table 3.2 and Table 3.3.

Reptiles

As vertebrates they do have a spine. The skin is covered with horny scales.

Possible causes are:

• Snakes. In contrast to other limbless reptiles they have no eyelids.
  • Terrestrial snakes
    • Diagnosis & Treatment
      North America
      Mexico and Central America
      South America and the West Indies
      Europe
      North Africa, Near and Middle East
      Central and Southern Africa
      The Far East
      Indian Subcontinent and Southeast Asia
      Australia and the Pacific Islands
    • Morphological identification key
    • Distribution tables (choose region or animal)
      
    • Biological tables (choose region)
    • Biomedical database (choose snake family)

• Heloderma spp. (Beaded lizard and Gila monster). Sturdy body, 2 pairs of legs. Only occur in the southwest of the USA, in western Mexico and in Central America. 
  • Biomedical database