Search Our Scientific Publications & Authors

Toxicon 2020 Oct 15;186:126-140. Epub 2020 Aug 15.

Laboratório de Imunoquímica, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Avenida Rodrigo Octávio Jordão Ramos, 6200, CEP 69077-000, Coroado II, Manaus, Amazonas, Brazil.

Freshwater stingrays are cartilaginous fish with stingers at the base of their tail. The stinger is covered with an epithelium containing mucous and venom glands. Human envenomation usually occurs when a person steps on a stingray hiding in the sand and the fish sinks its stinger into the victim, causing an extremely painful wound which generally leads to tissue necrosis. Read More

Childs Nerv Syst 2020 08 2;36(8):1811-1816. Epub 2020 May 2.

Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica.

Stingray injuries are rare, mostly causing injuries to the lower extremities but occasionally fatal if there is direct puncture of the thorax, abdomen, or neck. Direct combined stingray injury to the central nervous system has not been reported in the literature. Herein we present the case of a 12-year-old boy who, while wading at the seashore of the Costa Rica's Pacific Ocean, sustained a combined oblique penetrating injury to the C6 vertebra caused by a Stingray. Read More

Fish Shellfish Immunol 2019 Oct 16;93:832-840. Epub 2019 Aug 16.

Laboratório de Bioquímica e Biofísica, Instituto Butantan, Brazil; Laboratório Multidisciplinar de Pesquisa, Universidade São Francisco, Brazil. Electronic address:

Stingrays skin secretions are largely studied due to the human envenoming medical relevance of the sting puncture that evolves to inflammatory events, including necrosis. Such toxic effects can be correlated to the biochemical composition of the sting mucus, according to the literature. Fish skin plays important biological roles, such as the control of the osmotic pressure gradient, protection against mechanical forces and microorganism infections. Read More

BMJ Case Rep 2019 Jul 2;12(7). Epub 2019 Jul 2.

Foot and Ankle Department, Royal Orthopaedic Hospital, Birmingham, UK.

We report the case of a returning traveller, a woman in her early 20s, who presents with chronic inflammation and infection of her left foot following a stingray strike. Surgery was performed to remove foreign material a remarkable 9 months after the initial injury. The case highlights the importance of the initial assessment and early management of stingray attacks and illustrates the potential need for exploration and debridement of problematic stingray wounds. Read More

J Emerg Med 2019 02;56(2):230-231

University of California San Diego School of Medicine, San Diego, California.

J Emerg Med 2019 02;56(2):229-230

Emergency Department, Grand Strand Regional Medical Center, Myrtle Beach, South Carolina.

Toxins (Basel) 2018 12 18;10(12). Epub 2018 Dec 18.

CIIMAR/CIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Av. General Norton de Matos, s/n, 4450-208 Porto, Portugal.

Venomous animals are found through a wide taxonomic range including cartilaginous fish such as the freshwater stingray occurring in South America, which can injure people and cause venom-related symptoms. Ensuring the efficacy of drug development to treat stingray injuries can be assisted by the knowledge of the venom composition. Here we performed a detailed transcriptomic characterization of the venom gland of the South American freshwater stingray . Read More

J Emerg Med 2019 02 22;56(2):231. Epub 2018 Nov 22.

Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York.

Toxicon 2018 Aug 25;150:168-174. Epub 2018 May 25.

Laboratório Especial de Dor e Sinalização, Instituto Butantan, São Paulo, SP, Brazil. Electronic address:

Freshwater stingray accidents cause an immediate, intense, and unrelieved pain which is followed by edema, erythema and necrosis formation. Treatment for stingray envenomation is based on administration of analgesic, antipyretic and anti-inflammatory drugs. Concerning pain control, it is prescribed to immerse punctured limb on hot water to alleviate pain. Read More

J Emerg Med 2018 08 24;55(2):213-217. Epub 2018 May 24.

Department of Emergency Medicine, University of California San Diego, San Diego, California; Division of Medical Toxicology, University of California San Diego, San Diego, California; Scripps Clinic Medical Group, La Jolla, California.

Background: Stingray injuries result in thousands of emergency department visits annually.

Objectives: This study aimed to assess the complication rate and outcome of field treatment with hot water immersion.

Methods: This was an on-site, prospective, observational study. Read More

Am J Trop Med Hyg 2018 03 18;98(3):929-932. Epub 2018 Jan 18.

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

A 47-year-old man was stung on the left ankle by a stingray while on vacation on the Island of Bubaque, Guinea-Bissau. The affected limb was initially treated with an attempt to suck out the venom and application of chewed plant root. The following 3 days, local pain gradually diminished, but then high fever erupted together with generalized symptoms and intense pain from the ankle. Read More

Rev Soc Bras Med Trop 2017 May-Jun;50(3):374-378

Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brasil.

Introduction: Freshwater stingray envenomations are an important cause of morbidity in riverine populations living in various regions of Brazil. The sequelae include temporary or permanent disability. This study aimed to identify sociodemographic, clinical, and therapeutic aspects related to stingray injuries in such populations. 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

J Occup Med Toxicol 2016 10;11:23. Epub 2016 May 10.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

Background: Marine stings and envenomation are fairly common in Malaysia. Possible contact to various marine life occurs during diving, fishing and food handling. Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment. Read More

J Travel Med 2016 Feb 8;23(2):tav022. Epub 2016 Feb 8.

Service des maladies infectieuses et tropicales, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83 bd de l'hôpital, 75013 Paris, France, PRES Sorbonne universités, Université Pierre et Marie Curie (UPMC), faculté de médecine Pitié-Salpêtrière, 91 bd de l'hôpital, 75013 Paris, France.

Background: Travel and aquatic activities are increasing in tropical regions. The risk and the spectrum of marine envenomation are unknown in travellers. This work aims to evaluate the prevalence and the characteristics of marine envenomations in returning travellers. Read More

Foot Ankle Spec 2016 Jun 25;9(3):275-8. Epub 2015 Jun 25.

Department of Orthopaedics, Brigham and Women's Hospital, Boston, Massachusetts

Background: Posterior tibial tendon dysfunction is a common cause of adult acquired flatfoot deformity. The cause of posterior tibial tendon dysfunction is often multifactorial and may include repetitive microtrauma, poor blood supply to the tendon, and, rarely, traumatic rupture.

Case Description: We present the case of a 69-year-old male with posterior tibial tendon dysfunction secondary to a stingray injury that occurred directly into the posterior tibial tendon. Read More

Toxins (Basel) 2015 Jun 18;7(6):2272-88. Epub 2015 Jun 18.

Evolution and Ecology Unit, Communications and Public Relations Division, Okinawa Institute of Science and Technology Graduate University, 1919-1 Tancha, Onna-son, Kunigami-gun, Okinawa 904-0495, Japan.

Freshwater stingrays cause many serious human injuries, but identification of the offending species is uncommon. The present case involved a large freshwater stingray, Potamotrygon motoro (Chondrichthyes: Potamotrygonidae), in the Araguaia River in Tocantins, Brazil. Appropriate first aid was administered within ~15 min, except that an ice pack was applied. Read More

Wilderness Environ Med 2015 Sep 30;26(3):375-9. Epub 2015 Apr 30.

Emergency Department, Thomas Jefferson University Hospital, Philadelphia, PA (Drs Pham and Randolph).

Stingray envenomation is a common occurrence. X-ray evaluation of stingray wounds is an unnecessarily misunderstood diagnostic concept. We present the case of a patient stung by a stingray with a prolonged and complicated course and permanent disability due to a retained barb. Read More

J Zoo Wildl Med 2014 Jun;45(2):428-32

A subadult female loggerhead sea turtle (Caretta caretta) was caught in a trawl net off the west coast of Florida with a spotted eagle ray (Aetobatus narinari) spine lodged in the left stifle. Surgical removal of the spine was performed and antibiotic treatment was initiated. Four weeks later, endoscopy revealed a second spine entering an intestinal lumen. Read More

Exp Biol Med (Maywood) 2014 May 25;239(5):601-9. Epub 2014 Mar 25.

Laboratory of Immunopathology, Institute Butantan, Avenue Vital Brasil 1500, 05503-900 São Paulo, SP, Brazil.

Freshwater stingray accidents cause intense pain followed by edema, erythema, and necrosis formation. Treatment for stingray envenomation is based on administration of analgesic, antipyretic, and anti-inflammatory drugs. This report evaluated the local inflammatory reaction-including edema formation, leukocyte recruitment, release of inflammatory mediators, and histopathological changes-after the intraplantar injection of Potamotrygon motoro stingray venom in mice. Read More

Emerg Med Clin North Am 2014 Feb;32(1):223-43

Department of Emergency Medicine, Johns Hopkins University, 1830 East Monument Street, Baltimore, MD 21287, USA. Electronic address:

This article describes the epidemiology and presentation of human envenomation from marine organisms. Venom pathophysiology, envenomation presentation, and treatment options are discussed for sea snake, stingray, spiny fish, jellyfish, octopus, cone snail, sea urchin, and sponge envenomation. The authors describe the management of common exposures that cause morbidity as well as the keys to recognition and treatment of life-threatening exposures. Read More

Dermatol Online J 2013 Aug 15;19(8):19261. Epub 2013 Aug 15.

University of Missouri School of Medicine.

Human injuries related to stingray attacks include deep puncture wounds, envenomation, and foreign body reactions owing to retained tail fragments. Herein we report a patient who sustained a stingray injury that produced a subcutaneous granulomatous dermatitis and panniculitis with necrobiosis and review the topic of stingray injuries. Read More

West J Emerg Med 2012 Feb;13(1):80-1

Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia.

J Thromb Thrombolysis 2011 May;31(4):464-71

Center of Advanced Study in Marine Biology, Faculty of Marine Science, Annamalai University, Portonovo, P.O. Box 608502, Tamil Nadu, India.

Stingray envenomation is one of the major problems in the marine and freshwater ecosystem. Accidents in human cause immediate, local and intense pain, erythema, edema, hemorrhage, tissue necrosis and secondary bacterial infection are also common. To determine the effect of two marine stingray species Dasyatis sephen and Aetobatis narinari venom extract on coagulation, fibrin(ogen)olytic, proteolytic activities. Read More

Rev Invest Clin 2009 Jan-Feb;61(1):11-7

Laboratorio de Entomología, Parasitologia y Medicina Tropical, Centro de Investigaciones Biomédicas, Decanato de Investigaciones, Universidad Nacional Experimental Francisco de Miranda.

Introduction: Stingrays are cartilaginous elasmobranches fishes that can cause severe and potentially fatal injuries in humans.

Objective: A descriptive and prospective survey was conducted to analyze epidemiological, clinical and treatment aspects of injuries caused by marine stingrays in Adicora, Paraguaná peninsula, Falcon State, a northwestern, semiarid region of Venezuela.

Methods: Between December 2006 and April 2007, patients with saltwater stingray injuries, attended in the ambulatory emergency service of Adicora, were clinically examined and interrogated. Read More

Ann Chir Plast Esthet 2009 Apr 3;54(2):156-60. Epub 2009 Feb 3.

Service de chirurgie plastique reconstructrice et esthétique, hôpital Edouard-Herriot, pavillon U2B, place d'Arsonval, 69003 Lyon, France.

The emergency care to stingrays envenomation permits, in the majority of cases, to limit the damage caused. In the case of delayed medical care, we can meet deep and extensive lesions that need to be thoroughly explored in order to better address their reconstruction. We report the case of a patient injured by freshwater stingray. Read More

Toxicon 2007 Oct 23;50(5):688-97. Epub 2007 Jun 23.

Laboratório de Biologia Celular, Instituto Butantan, São Paulo, Brazil.

Marine and freshwater stingrays are characterized by the presence of one to three mineralized serrated stingers on the tail, which are covered by epidermal cells secreting venom. When these animals are dorsally touched, the stinger can be introduced into the aggressor by a whip reflex mechanism of the tail, causing severe mechanical injuries and inoculating the venom. Accidents in humans are frequent causing intense local pain, oedema and erythema. Read More

J Emerg Med 2007 Jul 30;33(1):33-7. Epub 2007 May 30.

Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California, USA.

Stingray stings are common along coastal regions of this country and the world. The tail of the stingray contains a barbed stinger attached to a venom gland and contained within an integumentary sheath. During a sting, the stinger and sheath can become embedded in the soft tissue of the victim, and venom is injected into the wound. Read More

Am J Emerg Med 2007 Jan;25(1):96-7

Sarasota County Fire Department, Emergency Services, Sarasota, FL 34236, USA.

J Emerg Med 2006 Apr;30(3):345-7

Department of Emergency Medicine, UCSD Medical Center, University of California-San Diego, 200 West Arbor Drive, San Diego, CA 92103, USA.