Papers of the Week

Lesser weever fish are saltwater fish that are found on the Mediterranean and European coasts, over sandy and muddy seabed areas, typically around the summer season. These bottom dwellers have envenoming dorsal spines that sting when stepped on. Severe pain is the main symptom. Initial treatment involves wound irrigation, removal of spines if they are visible and immediate hot water immersion (HWI). Tetanus prophylaxis, leg elevation and analgesia are recommended after pain subsides. HWI treatment is described as immersion of the affected area in hot, but not scalding, water to tolerance (upper limit 45 °C) for 30-90 min or until there is significant pain relief. While HWI is an effective therapy for the pain control of marine envenomation, it presents a potential risk of thermal burn injury in the untrained or unsupervised. Here, we present a case of an iatrogenic thermal burn after HWI for the treatment of a weever fish sting.