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A case report on Chironex sp (box jellyfish) envenomation and literature review on the appropriate management

Authors: Luella Joy A. Escueta, MD, DPDS and Johannes F. Dayrit, MD, FPDS


The Chironex sp. or box jellyfish are extensively found in the oceans of the Philippines. Most jellyfish stings arise from this Cnidarian species. Cutaneous lesions are erythematous papules and vesicles in a ladder-like pattern. Treatment of jellyfish envenomation is directed at relieving local effects of the venom, preventing further nematocyst discharge, and controlling systemic reactions if present. We report a case of box jellyfish envenomation to provide valuable information on the clinical manifestations and and proper management of both immediate and delayed reactions.



Escueta, LJ & Dayrit, J. (2017). A case report on Chironex sp. (box jellyfish) envenomation and literature review on the appropriate management. Journal of the Philippine Dermatological Society, 26(1), 85-87.



Chironex, box jellyfish, envenomation

  1. 1. Lee N, Wu M, Tsai W, Deng J. A Case of Jellyfish Sting. Vet Human Toxicol. August 2001; 43(4):203-5.
  2. Haddad V, Silveira FL, Migotto AE. Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): Etiology and severity of accidents on the brazilian coast. Rev Inst Med Trop Sao Paulo. January 2010; 52(1):47-50.
  3. Ghosh SK, Bandyopadhyay D, Haldar S. Lichen planus-like eruption resulting froma jellyfish sting: a case report. J Med Case Rep. July 2009; 3:7421.
  4. Haddad V, Silveira FL, Cardoso JL, Morandini AC. A report of 49 cases of cnidarian envenoming from southeastern Brazilian coastal waters. Toxicon 40 May 2002; 1445-50.
  5. Veraldi S, Carrera C. Delayed cutaneous reaction to jellyfish. Int J Dermatol. 2000; 39:28-29.
  6. Currie BJ, Jacups SP. Prospective study of Chironex fleckeri and other box jellyfish stings in the “Top End” of Australia’s North Territory. Med J Aust. December 2005; 183(11):631-36.
  7. Guevara BEK, Dayrit JF, Haddad V. Delayed allergic dermatitis presenting as a keloid-like reaction caused by sting from an Indo-Pacific Portuguese man-o-war (Physalia utriculus). Clin Exp Dermatol. March 2017; 42(2): 182-84.
  8. Menahem S, Shvartzman P. Recurrent dermatitis from jellyfish envenomation. Can Fam Physician. Dec 1994;40:2116-1
  9. Daly JS, Scharf MJ. Bites and Stings of Terrestrial and Aquatic Life. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffel DJ. Fitzpatrick’s Dermatology in General Medicine 8th ed. New York: McGraw Hill; 2012.p.2584-89.
  10. Burnett JW, Calton GJ, Burnett HW. Jellyfish envenomation syndromes. J Am AcadDermatol 2000, 39:28-29.
  11. Mandojana RM. Dermatoses from the aquatic environment. In:Moschella SL, Hurley HJ, eds: Dermatology. 3rd ed. WB Saunders, Philadelphia;1992. p.2004-9.
  12. Tamanaha RH, Izumi AK. Persistent cutaneous hypersensitivity reaction after a Hawaiian box jellyfish sting (Carybdea alata). J Am Acad Dermatol 1996; 35:991-93.
  13. Cegolon L, Heymann WC, Lange JH, Mastrangelo G. Jellyfish stings and their management: A review. Mar Drugs. February 2013;11(2):523-50.
  14. Welfare P, Little M, Pereira P, Seymour J. An in-vitro examination of the effect of vinegar on discharged nematocysts of Chironex fleckeri. Diving Hyperb Med. March 2014;44(1):30-4.
  15. Boulware, DR. A Randomized, controlled field trial for the prevention of jellyfish stings with a topical sting inhibitor. J Travel Med 2006; 13(3):166-171

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A case report on Chironex sp (box jellyfish) envenomation and literature review on the appropriate management