Stonefish are members of the family Scorpaenidae, or scorpion fish. The family also includes lionfish. These fish are particularly good at camouflaging themselves in their surroundings. The fins of these prickly fish carry poisonous venom. This article describes the effects of a sting from such fish.
This is for information only, and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
Stonefish live in tropical waters, including the warm shorelines of the coastal United States. They are also considered prized aquarium fish, and are therefore found worldwide.
A stonefish sting causes intense pain and swelling at the site of the sting. Swelling can spread to affect an entire arm or leg within minutes.
Airways and lungs:
Heart and blood:
Severe pain at the site of the sting
Whitened color of the area around the site of the sting
Color of the area changes as the amount of oxygen supplying the area decreases
Wash the area with fresh water. Remove any foreign material at the wound site. Soak wound in the hottest water the patient can tolerate for 30 - 90 minutes while contacting your local emergency services.
Before Calling Emergency
Determine the following information:
Patient's age, weight, and condition
Name of fish
Time of the sting
Location of the sting
Poison Control, or a local emergency number
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound will be soaked in a cleaning solution and any remaining foreign material will be removed. Symptoms will be treated as appropriate, and some or all of the following procedures may be performed:
Blood and urine tests
EKG (electrocardiogram, or heart tracing)
Fluids through a vein (by IV)
Medication (antiserum) to reverse the effect of the venom
Medication to treat symptoms
Tetanus shot, if necessary
Recovery usually takes about 24 - 48 hours. Outcome often depends on how much poisonous venom entered the body, the location of the sting, and how soon treatment is received. Numbness or tingling may persist for several weeks after the sting. Skin breakdown is sometimes severe enough to require surgical treatment.
A puncture to the patient's chest or abdomen may lead to death.
If scuba diving or snorkeling, learn to identify potentially poisonous or otherwise dangerous sea creatures and their habits.
Isbister GK, Caldicott DG. Trauma and evenomations from marine fauna. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 196.
Auerbach PS. Envenomation by Aquatic Vertebrates. In: Auerbach PS, ed. Wilderness Medicine. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2011:chap 81.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.