Acantotoxic accident cellulite and its distinctiveness: a case report

Abstract

INTRODUCTION: Acantotoxic accidents caused by skates (fish) are routinely caught in Brazil. It is more common in the northern region, especially from June to August, due to the season of river beaches and greater contact with rivers, dams and freshwater lakes: natural habitat of those species. It has an intense and also late inflammatory character, being a poison composed of polypeptides with thermolabile properties. There is no antivenom for those cases in Brazil. The treatment is based on symptom control and prevention of secondary infection, with status for the late effects of the poison. OBJECTIVES: To review emergency management and medical follow-up of an acantotoxic accident case in a pediatric patient and report the singularities related to this variety of accidents. METHODS: A case report of a 9-year-old boy admitted to a pediatric emergency department of a Federal District School Hospital, with a history of freshwater stingray injury, a clinical presentation of cellulitis and a dragged course. RESULTS: Regarded evolution compared to usual cellulitis patterns, requiring the antibiotic change and late signs of a form of necrotic formation. CONCLUSION: The approach to cellulitis was redirected due to the etiological factor correlated to the acantotoxic accident, implying to broaden the spectrum for gram-negative and anaerobic bacteria. It was then allowed to resolve and prevent more serious complications, such as late necrosis.