NON FATAL PENETRATING FACIAL INJURY DUE TO STINGRAY FISH BARB: A CASE STUDY AND REVIEW OF LITERATURE

A. Elnaggar, J. A. Sukhun, M. H. Attia

Abstract:
Background. Stingray attacks are frequently classified unintentional. Clinically, victims may present with a combination of traumatic injuries and envenomation effects. The traumatic component has a deceiving external appearance in comparison to the local deep tissue damage by the venom. We aimed to document the unique injuries and management of a stingray facial trauma in a young adult female beach goer.
Methods. Clinical examination revealed a patterned superficial abrasion with a small laceration at the lower right-side of the jaw. Intraoral examination showed a larger ulcer related to the wound track.
Results. Despite the lack of systematic manifestations to the venom, positive lab findings are correlated with acute inflammatory response to the tissue damage by the stingray venom particularly, the unspecified elevated C-reactive protein and leukocytosis with increased neutrophils and monocytes counts. Limited x-ray and ultrasonography revealed a well demarcated foreign body in the mandible. She was managed with intravenous antibiotics, pain control with paracetamol, and a timely surgical removal of the foreign body.
Conclusion. The patterned injury was ascribed to the spine and whip-like tail of a small stingray fish.
Keywords: stingray attack, gulf area, radiological investigations, patterned injury.