Abstract
A 31-year-old male visited the emergency department after scuba diving at a local beach in Guam. On arrival, he complained of severe pain in his right thumb and index finger. He was diagnosed with stonefish sting. The patient was given an oral steroid and antibiotics. Despite improvement in the pain and swelling, the symptoms recurred upon his return to Japan. The patient was transferred to our hospital with suspected necrotizing fasciitis based on the laboratory finding of elevated creatine phosphokinase (CPK) of 619IU/l at the local hospital. On admission, the CPK level was 299IU/l, so he was given 15mg of oral prednisolone (PSL) and cefazolin (CEZ). Despite temporary improvement of the swelling and redness, the symptoms worsened on the third day of admission. However, the symptoms subsequently improved, and PSL was tapered to 10mg after 5 days. His right hand swelling was markedly reduced after 21 days of PSL. His symptoms were supposed to have been related to delayed allergic reaction to stonefish venom.Skin Research, 12: 442-445, 2013
