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Lionfish and Stonefish Envenomation

Background

The family Scorpaenidae represents a large array of fish characterized by the ability to envenomate with various types of specialized spines. This group of fish is responsible for the second most common piscine envenomation, after stingrays.

Unfortunately, this family of fish has a confusing variety of common names, which tends to hinder accurate field identification, classification, and understanding of envenomation. It is helpful to consider the Scorpaenidae family as three distinct groups, based upon their venom organ structure and toxicity.

These three groups and their representative genera include the following (see the images below):

Pterois – Long, slender spines with small venom glands and a less potent sting (eg, lionfish, zebrafish, butterfly cod)

Lionfish (Pterois volitans) have long, slender spi

Lionfish (Pterois volitans) have long, slender spines with small venom glands, and they have the least potent sting of the Scorpaenidae family. Courtesy Dee Scarr.

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Scorpaena – Shorter and thicker spines with larger venom glands and a more potent sting (eg, scorpionfish, bullrout, sculpin)

Scorpionfish (genus Scorpaena) have shorter, thick

Scorpionfish (genus Scorpaena) have shorter, thicker spines with larger venom glands than lionfish do, and they have a more potent sting. Courtesy Dee Scarr.

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Synanceia – Stout, powerful spines with highly developed venom glands and a potentially fatal sting (eg, stonefish)

Stonefish (genus Synanceia) have short, stout spin

Stonefish (genus Synanceia) have short, stout spines with highly developed venom glands, and they have a potentially fatal sting. Courtesy Paul S. Auerbach, MD.

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Injury and envenomation are reported in the natural environment (eg, accidental exposure to waders, divers, fishermen), as well as in the home setting (eg, handling by unwary marine aquarists).

See Deadly Sea Envenomations, a Critical Images slideshow, to help make an accurate diagnosis.

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