The North Borneo state of Sabah is known worldwide for its beautiful islands and dive sites. Local hospitals deal with a number of marine-related injuries, including marine fauna envenomation by Scorpaenidae and Synanceiidae families of fish. We report a case of a tourist who presented with excruciating pain on her right foot after stepping on a stonefish. Despite being given parenteral analgesia and regional anaesthesia, the pain persisted. Her pain improved after she soaked her foot in hot water for about 30 minutes. No further treatment was required. We reviewed the literature comparing this inexpensive mode of treatment with other conventional treatments. We also explored the possibility of using hot water immersion for treatment of envenomation by other types of marine animals.
Fishes, Poisonous ; Fish Venoms ; Water ; Primary Health Care

Skin necrosis of the foot, oedema and lymphangitis from stonefish (Synanceia verrucosa) sting are complications well known for a long time and with potential long-term sequelae. Literature reports of stonefish envenomation give no specific reference on soft tissue management and surgical reconstruction. This is the first report describing a case of foot stonefish envenomation treated by vacuum-assisted closure therapy as an easy to use, accessible and simple adjuvant tool for management of large soft tissue necrosis.
Animals ; Bites and Stings ; complications ; surgery ; Dermatologic Surgical Procedures ; Fishes, Poisonous ; Foot Injuries ; surgery ; Humans ; Lymphangitis ; etiology ; surgery ; Male ; Middle Aged ; Necrosis ; Negative-Pressure Wound Therapy ; Skin ; pathology ; Skin Transplantation