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Portuguese Man-Of-War Sting

The Portuguese Man-of-War (also called “Bluebottle”) is a jelly-like marine animal found in tropical ocean and bays. Man-of-War tentacles have coiled stingers that contain a very powerful and painful venom. The Man-of-War sting is intended to paralyze small fish until it can be eaten. In humans, reactions can be mild to moderate. In rare cases, it can be life threatening.

After a sting, the tentacles leave long, stringy red welts on the skin. The welts last from minutes to hours. There is local pain, burning, swelling, and redness. This rash may come and go for up to six weeks. Cramps, fever, sweating, weakness, faintness, dizziness, nausea, vomiting and diarrhea may also occur in stronger reactions. Over-the-counter medicines are used to treat generalized symptoms of pain, itching, and swelling. Severe reactions require hospital treatment.

Home Care:

  • If your doctor has prescribed medicines, take them as directed.

  • Apply an ice pack over the injured area for 20 minutes every 2 hours for the first day. Continue this 3-4 times a day for the next few days until the pain and swelling improve.

  • LanaCort cream (hydrocortisone and benzocaine) or similar over-the-counter medicines will reduce the itching and local pain.

  • Oral Benadryl (diphenhydramine) is an antihistamine available at drug and grocery stores. Unless a prescription antihistamine was given, Benadryl may be used to reduce itching if large areas of the skin are involved. Use lower doses during the daytime and higher doses at bedtime since the drug may make you sleepy. [NOTE: Do not use Benadryl if you have glaucoma or if you are a man with trouble urinating due to an enlarged prostate.] Claritin (loratidine) is an antihistamine that causes less drowsiness and is a good alternative for daytime use.

  • You may use ibuprofen (Motrin, Advil) for inflammation and pain, unless another pain medicine was prescribed. [NOTE: If you have chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your doctor before using these medicines.]

Prevention:

  • Before swimming in oceans or bays, check local beach reports for warnings of Portuguese Man-of-War. Do not swim in the water when they are present.

  • If you find one washed up on the beach, do not touch it. Even dead Man-of-Wars or detached tentacles can sting.

  • First, apply vinegar, baking soda, ammonia or citrus juice to inactivate the stinging cells. Leave in place for 30 minutes.

  • Remove tentacles with a gloved hand, stick, towel or swim fins. Rinse area with salt water. Apply ice to control pain.

  • Seek medical attention for moderate to severe reactions.

Follow Up

with your doctor or as advised by our staff or if you develop a recurring rash.

Get Prompt Medical Attention

if any of the following occur:

  • Symptoms worsen

  • The rash becomes more red, painful, warm or drains fluid, or open sores appear

  • Shortness of breath or chest pain

  • Dizziness, weakness or fainting

  • Fever of 100.4°F (38ºC) or higher, or as directed by your healthcare provider

  • Pink or red urine

 

 
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