146 results match your criteria Cnidaria Envenomation
Toxins (Basel) 2018 Mar 23;10(4). Epub 2018 Mar 23.
Institute of Pharmacology and Toxicology, Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria.
Cnidaria include the most venomous animals of the world. Among Cnidaria, Scyphozoa (true jellyfish) are ubiquitous, abundant, and often come into accidental contact with humans and, therefore, represent a threat for public health and safety. The venom of Scyphozoa is a complex mixture of bioactive substances-including thermolabile enzymes such as phospholipases, metalloproteinases, and, possibly, pore-forming proteins-and is only partially characterized. Read More
Zootaxa 2017 Nov 7;4344(2):277-290. Epub 2017 Nov 7.
Tropical Biosphere Research Center University of the Ryukyus, Sesoko Station, 3422 Sesoko, Motobu, Okinawa 905-0227, Japan..
A new species of hydrozoan jellyfish belonging to the order Limnomedusae is reported from the Ryukyu Archipelago, Southern Japan. The species belongs to the genus Scolionema, which prior to this study includes just a single valid species, S. suvaense. Read More
J Proteomics 2017 Aug 21;166:83-92. Epub 2017 Jul 21.
Institute for Molecular Bioscience, University of Queensland, St. Lucia, QLD 4072, Australia. Electronic address:
More than a century of research on sea anemone venoms has shown that they contain a diversity of biologically active proteins and peptides. However, recent omics studies have revealed that much of the venom proteome remains unexplored. We used, for the first time, a combination of proteomic and transcriptomic techniques to obtain a holistic overview of the venom arsenal of the well-studied sea anemone Stichodactyla haddoni. Read More
Toxins (Basel) 2017 07 7;9(7). Epub 2017 Jul 7.
Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI 96813, USA.
Lion's mane jellyfish () stings cause severe pain and can lead to dangerous systemic effects, including Irukandji-like syndrome. As is the case for most cnidarian stings, recommended medical protocols in response to such stings lack rigorous scientific support. In this study, we sought to evaluate potential first aid care protocols using previously described envenomation models that allow for direct measurements of venom activity. Read More
Toxins (Basel) 2017 04 26;9(5). Epub 2017 Apr 26.
Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA.
Stings from the hydrozoan species in the genus cause intense, immediate skin pain and elicit serious systemic effects. There has been much scientific debate about the most appropriate first aid for these stings, particularly with regard to whether vinegar use is appropriate (most current recommendations recommend against vinegar). We found that only a small percentage (≤1. Read More
Emerg Med Clin North Am 2017 May 15;35(2):321-337. Epub 2017 Mar 15.
Department of Emergency Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Alway Building M121, MC 5119, Stanford, CA 94305-2200, USA.
Venomous aquatic animals are hazardous to swimmers, surfers, divers, and fishermen. Exposures include mild stings, bites, abrasions, and lacerations. Severe envenomations can be life threatening. Read More
Med Sante Trop 2017 Feb;27(1):105-108
CHU Pellegrin, Bordeaux, France.
We report the first case of rhabdomyolysis following envenomation by a Physalia sp in New Caledonia. Systemic envenomation by this marine hydrozoan is well known, including myalgia as a commonly reported clinical feature. Nonetheless, a related increase in muscle enzymes, featuring rhabdomyolysis, has not previously been described. Read More
Rev Soc Bras Med Trop 2017 Jan-Feb;50(1):130-134
Departamento de Oceanografia e Limnologia, Universidade Federal do Maranhão, São Luis, Maranhão, Brasil.
Introduction:: The clinical and epidemiological aspects associated with Portuguese man-of-war envenomation were investigated and characterized.
Methods:: Data from recorded envenomation events between 2005 and 2013 were provided by the GBMar (Group of Firemen Maritime of Maranhão State) and SEMUSC (Municipal Secretary of Security with Citizenship).
Results:: Most victims were children, and clinical manifestations included intense pain, edema, erythema, and rare systemic manifestations. Read More
Toxins (Basel) 2017 03 15;9(3). Epub 2017 Mar 15.
Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI 96822, USA.
Cnidarian envenomations are the leading cause of severe and lethal human sting injuries from marine life. The total amount of venom discharged into sting-site tissues, sometimes referred to as "venom load", has been previously shown to correlate with tentacle contact length and sequelae severity. Since <1% of cnidae discharge upon initial tentacle contact, effective and safe removal of adherent tentacles is of paramount importance in the management of life-threatening cubozoan stings. Read More
Sci Rep 2017 Jan 23;7:41065. Epub 2017 Jan 23.
Paracelsus Medical University, Institute of Pharmacology and Toxicology, Strubergasse 21, Salzburg, A-5020, Austria.
Cnidarians may negatively impact human activities and public health but concomitantly their venom represents a rich source of bioactive substances. Pelagia noctiluca is the most venomous and abundant jellyfish of the Mediterranean Sea and possesses a venom with hemolytic and cytolytic activity for which the mechanism is largely unknown. Here we show that exposure of mammalian cells to crude venom from the nematocysts of P. Read More
Integr Comp Biol 2016 11;56(5):973-988
Department of Evolution, Ecology, and Organismal Biology, The Ohio State University, Columbus, OH 43215, USA.
Cubozoans (box jellyfish) have a reputation as the most venomous animals on the planet. Herein, we provide a review of cubozoan prey capture and digestion informed by the scientific literature. Like all cnidarians, box jellyfish envenomation originates from structures secreted within nematocyte post-Golgi vesicles called nematocysts. Read More
J Am Acad Dermatol 2017 Jan 11;76(1):140-147. Epub 2016 Oct 11.
Dermatology, University of Pennsylvania Hospital, Philadelphia, Pennsylvania. Electronic address:
Global temperatures continue to rise, reaching new records almost every year this decade. Although the causes are debated, climate change is a reality. Consequences of climate change include melting of the arctic ice cap, rising of sea levels, changes in precipitation patterns, and increased severe weather events. Read More
Int J Environ Res Public Health 2016 07 19;13(7). Epub 2016 Jul 19.
Department of Emergency Nursing, School of Nursing, Second Military Medical University, Shanghai 200433, China.
Background: Jellyfish envenomation is common along the coastal area, and can cause severe consequences. Naval personnel are among the high-risk population for this injury. The aim of this study was to assess knowledge regarding jellyfish envenomation among naval personnel in a navy unit in northeast China. Read More
Mar Drugs 2016 Jul 8;14(7). Epub 2016 Jul 8.
Flanders Marine Institute, InnovOcean Site, Wandelaarkaai 7, Ostende 8400, Belgium.
There is a growing cause for concern on envenoming European species because of jellyfish blooms, climate change and globalization displacing species. Treatment of envenomation involves the prevention of further nematocyst release and relieving local and systemic symptoms. Many anecdotal treatments are available but species-specific first aid response is essential for effective treatment. Read More
PLoS One 2016 18;11(5):e0155719. Epub 2016 May 18.
College of Marine and Environmental Sciences and ARC Centre of Excellence in Coral Reef Studies, James Cook University, Townsville, QLD, Australia.
Identification of potentially harmful cubomedusae is difficult due to their gelatinous nature. The only hard structure of medusae, the statolith, has the potential to provide robust measurements for morphometric analysis. Traditional morphometric length to width ratios (L: W) and modern morphometric Elliptical Fourier Analysis (EFA) were applied to proximal, oral and lateral statolith faces of 12 cubozoan species. Read More
Toxicon 2016 Sep 8;119:1-7. Epub 2016 May 8.
Laboratório de Imunopatologia, Instituto Butantan, Av. Vital Brasil 1500, 05503-900 São Paulo, SP, Brazil. Electronic address:
Jellyfish venoms are of medical and biotechnological importance, with toxins displaying antimicrobial, analgesic and anti-tumor activities. Although proteolytic enzymes have also been described, detailed characterisation of these proteins is scant in Olindias spp. High throughput mass spectrometry profiling of cnidarian venoms has become increasingly popular since the first description of the proteomic profile of putative toxins isolated from nematocysts of the hydrozoan jellyfish Olindias sambaquiensis describing the presence of orthologous enzymes as presented in venoms of advanced species as snakes. Read More
PLoS One 2016 21;11(4):e0154239. Epub 2016 Apr 21.
Research group of Oceanography and Plankton, National Agronomic Institute of Tunis, Tunis, Tunisia.
Jellyfish are of particular concern for marine finfish aquaculture. In recent years repeated mass mortality episodes of farmed fish were caused by blooms of gelatinous cnidarian stingers, as a consequence of a wide range of hemolytic, cytotoxic, and neurotoxic properties of associated cnidocytes venoms. The mauve stinger jellyfish Pelagia noctiluca (Scyphozoa) has been identified as direct causative agent for several documented fish mortality events both in Northern Europe and the Mediterranean Sea aquaculture farms. Read More
BMC Res Notes 2016 Feb 17;9:108. Epub 2016 Feb 17.
Epidemiology Bureau, Department of Disease Control, Ministry of Public Health, Nonthaburi, 10100, Thailand.
Background: Despite recent deaths caused by box jellyfish envenomation occurring on the islands of Samui and Pha-ngan in the Gulf of Thailand, many people do not believe box jellyfish can kill humans and many people dismiss the problem as insignificant. More evidence has been requested from the communities in order to evaluate the need for and the implementation of sustainable prevention measures. We aimed to determine the magnitude of cases of severe stinging by box jellyfish and describe the characteristics of these cases on the islands of Samui and Pha-ngan in Surat Thani Province from 1997 to 2015. Read More
Toxins (Basel) 2016 Jan 11;8(1). Epub 2016 Jan 11.
Békésy Laboratory of Neurobiology, Pacific Biosciences Research Center, School of Ocean and Earth Science and Technology, University of Hawaii at Manoa, Honolulu HI 96822, USA.
Despite the medical urgency presented by cubozoan envenomations, ineffective and contradictory first-aid management recommendations persist. A critical barrier to progress has been the lack of readily available and reproducible envenomation assays that (1) recapitulate live-tentacle stings; (2) allow quantitation and imaging of cnidae discharge; (3) allow primary quantitation of venom toxicity; and (4) employ rigorous controls. We report the implementation of an integrated array of three experimental approaches designed to meet the above-stated criteria. Read More
Toxicon 2015 Dec 4;108:232-9. Epub 2015 Nov 4.
Marine Bio-pharmaceutical Institute, Second Military Medical University, Shanghai 200433, China; Department of Marine Biotechnology, Faculty of Naval Medicine, Second Military Medical University, Shanghai 200433, China. Electronic address:
Previously, we established delayed jellyfish envenomation syndrome (DJES) models and proposed that the hemorrhagic toxins in jellyfish tentacle extracts (TE) play a significant role in the liver and kidney injuries of the experimental model. Further, we also demonstrated that metalloproteinases are the central toxic components of the jellyfish Cyanea capillata (C. capillata), which may be responsible for the hemorrhagic effects. Read More
Comp Biochem Physiol C Toxicol Pharmacol 2016 Feb 30;180:31-9. Epub 2015 Oct 30.
Department of Cell Biology and Genetics, Guangxi Medicinal University, Nanning 530021, China. Electronic address:
The present work investigated the in vitro cytotoxicity of nematocyst venom (NV) from Chrysaora helvola Brandt (C. helvola) jellyfish against human MCF-7 and CNE-2 tumor cell lines. Potent cytotoxicity was quantified using the MTT assay (LC50=12. Read More
J Travel Med 2015 Jul-Aug;22(4):269-71
Koç University Hospital, Istanbul, Turkey.
In a marine envenomation, identification of the culprit organism can be difficult. In this case report, we present our method to identify snakelocks anemone (Anemonia viridis or formerly Anemonia sulcata) as the culprit of a severe toxic skin reaction. A. Read More
Toxins (Basel) 2015 Jun 18;7(6):2251-71. Epub 2015 Jun 18.
Venom Evolution Lab, School of Biological Sciences, the University of Queensland, St. Lucia 4072, QLD, Australia.
Cnidarians are the oldest extant lineage of venomous animals. Despite their simple anatomy, they are capable of subduing or repelling prey and predator species that are far more complex and recently evolved. Utilizing specialized penetrating nematocysts, cnidarians inject the nematocyst content or "venom" that initiates toxic and immunological reactions in the envenomated organism. Read More
BMC Genomics 2015 May 27;16:407. Epub 2015 May 27.
Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Background: The box jellyfish, Chironex fleckeri, is the largest and most dangerous cubozoan jellyfish to humans. It produces potent and rapid-acting venom and its sting causes severe localized and systemic effects that are potentially life-threatening. In this study, a combined transcriptomic and proteomic approach was used to identify C. Read More
Wilderness Environ Med 2015 Sep 29;26(3):422-9. Epub 2015 Apr 29.
Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Jellyfish have a worldwide distribution. Their stings can cause different reactions, ranging from cutaneous, localized, and self-limited to serious systemic or fatal ones, depending on the envenoming species. Several first aid treatments are used to manage such stings but few have evidence behind their use. Read More
Clin Toxicol (Phila) 2015 Feb 22;53(2):137. Epub 2015 Jan 22.
Division of Medical Toxicology, Department of Emergency Medicine, University of California San Diego Health System , San Diego, CA , USA.
J Venom Res 2014 23;5:22-32. Epub 2014 Jul 23.
Department of Earth, Environment and Life Sciences, University of Genova, I-16132 Genova, Italy.
Cnidarian jellyfish are viewed as an emergent problem in several coastal zones throughout the world. Recurrent outbreaks pose a serious threat to tourists and bathers, as well as to sea-workers, involving health and economical aspects. As a rule, cnidarian stinging as a consequence of nematocyst firing induces merely local symptoms but cardiovascular or neurological complications can also occur. Read More
Diving Hyperb Med 2014 Sep;44(3):172-3
Queensland Emergency Medical Research Foundation, James Cook University, Queensland.
Diving Hyperb Med 2014 Sep;44(3):172
Biostatistics and Data Management Core, John A Burns School of Medicine, University of Hawaii.
Hong Kong Med J 2014 Oct;20(5):460-3
Division of Hand and Microsurgery, Department of Orthopaedics, Prince of Wales Hospital, Shatin, Hong Kong.
We report a case of digital ischaemia in a 31-year-old man who presented with sudden hand numbness, swelling, and cyanosis 4 days after a jellyfish sting. This is a rare complication of jellyfish sting, characterised by a delayed but rapid downhill course. Despite serial monitoring with prompt fasciotomy and repeated debridement, he developed progressive ischaemia in multiple digits with gangrenous change. Read More
Toxicon 2014 Dec 5;91:114-25. Epub 2014 Oct 5.
Prevor, Moulin de Verville, 95760 Valmondois, France. Electronic address:
Jellyfish blooms occur throughout the world. Human contact with a jellyfish induces a local reaction of the skin, which can be painful and leave scaring. Systemic symptoms are also observed and contact with some species is lethal. Read More
Diving Hyperb Med 2014 Jun;44(2):102-3
Emergency Department Cairns Base Hospital and Australian Institute of Tropical Health and Medicine; School of Public Health and Tropical Medicine, Centre for Biodiscovery and Molecular Development of Therapeutics, Faculty of Medicine, Health and Molecular Sciences, James Cook University, Queensland, Australia.
Diving Hyperb Med 2014 Jun;44(2):102
Senior Staff Specialist, Emergency Department, The Townsville Hospital and Senior Lecturer (Adj.), School of Marine and Tropical Biology, James Cook University, Queensland.
Am Fam Physician 2014 May;89(10):Online
Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, TX, USA.
Diving Hyperb Med 2014 Mar;44(1):30-4
Queensland Emergency Medical Research Foundation (QEMRF), Queensland Tropical Health Alliance, School of Public Health and Tropical Medicine, Centre for Biodiscovery and Molecular Development of Therapeutics, Faculty of Medicine, Health and Molecular Sciences, James Cook University, Queensland, Australia.
Objective: To determine the effect acetic acid (vinegar) has on discharged nematocysts in a simulated sting from Chironex fleckeri.
Method: This research was performed in 2 parts: 1 C. fleckeri tentacles placed on amniotic membrane were electrically stimulated, and venom washings collected before and after application of vinegar. Read More
J Venom Anim Toxins Incl Trop Dis 2014 Mar 25;20(1):10. Epub 2014 Mar 25.
São Paulo Experimental Coast Campus, São Paulo State University (UNESP - Univ Estadual Paulista), São Vicente, São Paulo State, Brazil.
Background: Although the hydrozoan Olindias sambaquiensis is the most common jellyfish associated with human envenomation in southeastern and southern Brazil, information about the composition of its venom is rare. Thus, the present study aimed to analyze pharmacological aspects of O. sambaquiensis venom as well as clinical manifestations observed in affected patients. Read More
J R Nav Med Serv 2013 ;99(3):169-70
Department of Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust.
Cnidaria stings cause a wide range of cutaneous and systemic symptoms, normally occurring shortly after the venomous insult (1). We report a case of worsening cutaneous reaction over an eight-year period following a Cnidaria attack sustained whilst maritime swimming. The lesion was characterised by severe, ulcerating chronic inflammation that required wide local excision and skin grafting. Read More
Toxicon 2014 Apr 6;81:48-53. Epub 2014 Feb 6.
Department of Marine Biotechnology, Faculty of Naval Medicine, Second Military Medical University, Shanghai 200433, China. Electronic address:
Using the tentacle extract (TE) from the jellyfish Cyanea capillata, we have previously established a delayed jellyfish envenomation syndrome (DJES) model, which is meaningful for clinical interventions against jellyfish stings. However, the mechanism of DJES still remains unclear. Thus, this study aimed to explore its potential mechanism by detecting TE-induced microvasculature alterations in vivo and ex vivo. Read More
Trop Doct 2014 Apr 11;44(2):106-7. Epub 2013 Dec 11.
Medical Student, Loma Linda University School of Medicine, USA.
Box jellyfish are highly venomous and numerous possible treatments for envenomation have already been reported in the published literature. The hand of a 55-year-old scuba diver was stung in the Gulf of Guinea resulting in two crops of coalescing vesicles with intense pain and lymphadenopathy. Traditional therapies such as hot water, cold packs and acetic acid were ineffective. Read More
Cochrane Database Syst Rev 2013 Dec 9(12):CD009688. Epub 2013 Dec 9.
Sydney School of Medicine, The University of Sydney, Edward Ford Building, A27, Sydney, NSW, Australia, 2006.
Background: Jellyfish envenomations are common amongst temperate coastal regions and vary in severity depending on the species. Stings result in a variety of symptoms and signs, including pain, dermatological reactions and, in some species, Irukandji syndrome (including abdominal/back/chest pain, tachycardia, hypertension, sweating, piloerection, agitation and sometimes cardiac complications). Many treatments have been suggested for the symptoms and signs of jellyfish stings. Read More
Adv Mar Biol 2013 ;66:1-85
CSIRO Marine and Atmospheric Research, Castray Esplanade, Hobart, Tasmania, Australia. Electronic address:
Irukandji stings are a leading occupational health and safety issue for marine industries in tropical Australia and an emerging problem elsewhere in the Indo-Pacific and Caribbean. Their mild initial sting frequently results in debilitating illness, involving signs of sympathetic excess including excruciating pain, sweating, nausea and vomiting, hypertension and a feeling of impending doom; some cases also experience acute heart failure and pulmonary oedema. These jellyfish are typically small and nearly invisible, and their infestations are generally mysterious, making them scary to the general public, irresistible to the media, and disastrous for tourism. Read More
Toxicon 2013 Dec 29;76:310-5. Epub 2013 Oct 29.
Emergency Department, Cairns Base Hospital, Cairns 4870, Australia; Queensland Tropical Health Alliance (QTHA), James Cook University, McGregor Road, Cairns 4878, Australia; School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, McGregor Road, Cairns 4878, Australia. Electronic address:
Although Chironex fleckeri and Carukia barnesi cause significant human envenomation, research into their effects in human models or human cells has been limited. In this in vitro study we have presented data that shows that although C. fleckeri is highly cytotoxic to human cardiac and skeletal muscle cells, C. Read More
Bull Soc Pathol Exot 2013 Oct 26;106(4):229-32. Epub 2013 Sep 26.
Service des maladies infectieuses et tropicales, Groupe hospitalier Pitié-Salpêtrière, Paris, France.
We report a case of box-jellyfish related envenomation in a 40 year old tourist that occurred in Sihanoukville, Cambodia, in the Gulf of Thailand. Symptoms that appeared within a few minutes associated intense pain, hand edema and large edematous and erythematous flagellations in the stung skin areas. Antibiotics and corticosteroids were delivered. Read More
Intern Emerg Med 2014 Feb 22;9(1):103-4. Epub 2013 Sep 22.
Department of Emergency Medicine, Yale University School of Medicine, 367 Cedar Street, New Haven, CT, 06510, USA.
Toxins (Basel) 2013 Aug 2;5(8):1343-52. Epub 2013 Aug 2.
Centre Antipoison, Hôpital Sainte Marguerite, 270 Boulevard Sainte Marguerite, Marseille 13009, France.
Clinical marine toxicology is a rapidly changing area. Many of the new discoveries reported every year in Europe involve ecological disturbances--including global warming--that have induced modifications in the chorology, behavior, and toxicity of many species of venomous or poisonous aquatic life including algae, ascidians, fish and shellfish. These changes have raised a number of public issues associated, e. Read More
Toxicon 2013 Nov 2;74:1-7. Epub 2013 Aug 2.
Department of Marine Biotechnology, Faculty of Naval Medicine, Second Military Medical University, Shanghai 200433, China.
Our previous studies have shown that tentacle extract (TE) from the jellyfish Cyanea capillata could induce a delayed jellyfish envenomation syndrome with severe multiple organ dysfunctions, among which renal injury with tubular necrosis seemed to be most serious. So, in this study, we aimed to explore the toxic effect of TE on rat renal tubular epithelial NRK-52E cells. Based on the previous findings that TE could cause oxidative damage in erythrocytes, the effects of TE on cell oxidative stress conditions, including ROS production and lipid peroxidation, and mitochondrial dysfunction associated with cell death were investigated in NRK-52E cells. Read More
Rev Soc Bras Med Trop 2013 Sep-Oct;46(5):641-4
Introduction: Portuguese man-of-war, Physalia physalis (Linnaeus, 1758), are cnidarians capable of discharging intracellular organelles filled with venom, resulting in severe envenomation in humans.
Methods: We report the clinical and therapeutic aspects of 331 accidents involving Portuguese man-of-war in an outbreak on the coast of the State of São Paulo, Brazil.
Results: The clinical manifestations of envenomation were rare and mild and mostly local, systemic reactions; there was a low rate of late complications. Read More
Diving Hyperb Med 2013 Mar;43(1):9-15
School of Marine and Tropical Biology, James Cook University, Australia.
Introduction: We reviewed the occurrence, trends, definition and severity of the Irukandji syndrome for the Cairns region of North Queensland, Australia.
Methods: A retrospective analysis of patient files from two sources was conducted: historic accounts kept by Dr Jack Barnes for the period 1942 to 1967, and records from the Emergency Unit in Cairns Base Hospital for 1995 to 2007.
Results: There has been a significant increase in the length of the Irukandji season since it was first reliably recorded (15 days in 1961; 151 days in 2002); however, annual numbers of envenomations were highly variable. Read More
Mar Drugs 2013 Feb 22;11(2):523-50. Epub 2013 Feb 22.
Department of Molecular Medicine, Padua University, Padua 35128, Italy.
Jellyfish (cnidarians) have a worldwide distribution. Despite most being harmless, some species may cause local and also systemic reactions. Treatment of jellyfish envenomation is directed at: alleviating the local effects of venom, preventing further nematocyst discharges and controlling systemic reactions, including shock. Read More
Diving Hyperb Med 2012 Dec;42(4):214-23
School of Marine and Tropical Biology, James Cook University, Australia.
Irukandji syndrome is a poorly defined set of symptoms that occur after envenoming by certain species of jellyfish, primarily cubozoans or 'box jellyfish'. Envenomed victims can show symptoms ranging from headaches, severe pain, nausea and vomiting to pulmonary oedema, cardiac failure and severe hypertension resulting in death. Historically, this syndrome appears to have been misdiagnosed and reported cases are undoubtedly a significant underestimation of the prevalence of this syndrome. Read More