Stonefish (Synanceja spp.) from A to Z and their Envenomation: a Review

The Stonefish is believed to be the most venomous, dangerous, and even fatal fish to human and animals that currently known in the worldwide. Their venom apparatus involve 12-13 dorsal ‘hypodermic’, 2 pelvic, and 3 anal spines, which contain venom, excepting the ornate pectoral spines that are not venomous. Venom with some activities contains a mixture of enzyme and non-enzyme proteins, like stonustoxin, trachynilysin, verrucotoxin and Neo verrucotoxin. They act on receptors and ion channels, with various mechanisms; and cause marked local and systemic complications in envenomed animals. Most typical envenomation management protocols consist of initial resuscitation, symptomatic relief with hot water (45ºC) therapy, antivenom for systemic or severe local signs, and surgical removal of spines or other foreign bodies. There were a lot of recommends about use of hot water immersion, early on-site, as a first aid measure. Antibiotics are proposed for deep puncture injuries, due to the high incidence of ulceration, necrosis, and secondary infections. As in everything else, prevention is better than cure; and must wear shoes and step with judgment in stonefish aqueous territories!