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Master Thesis

Les envenimations par cnidaires en Nouvelle-Calédonie, étude rétrospective entre 2005 à 2017 au Centre Hospitalier Territorial de Nouméa

Abstract : Aim. Describe epidemiological, clinical and therapeutic characteristics of cnidarian envenomations managed at Noumea Territorial Hospital Center (CHT). Methods. Retrospective study including all patients admitted to CHT for accident implying a cnidarian (exclusion of coral wounds without other sign) from December 30th, 2005 to September 7th, 2017. Medical files were collected through the PMSI coding system and the DxCare software used in the Emergency Department. Results. 75 patients were included: 38 envenomations by mobile form of cnidarian (3 by Physalia spp, others by jellyfish) and 37 cases of contact lesions with corals. Median age was 19 years old (IQR: 8- 32). Patients envenomned by jellyfish were significantly younger than those injured by corals (p<0,001). Augmentation of number of jellyfish’s envenomations was noticed from 2012 (6 cases from 2005 to 2011 vs 32 cases from 2012 to 2017). Pain was the main symptom of envenomation by cnidarian (61% of cases). Patients envenomned by a mobile form of cnidarian showed an erythema (37%), papules (24%) and pruritus (21%). Main signs observed after contact with corals was erythema (76%), wound (57%), surinfection (35%) and local oedema (32%). One envenomation by Physalia spp. induced a rhabdomyolysis with acute kidney injury and one envenomation by coral caused a myocarditis. Besides painkillers, treatment was composed of antihistaminics for 37% of jellyfish envenomations, and one antibiotherapy and one surgery for contact lesions by corals (respectively 84% and 46% of cases). No death or aftermath was noticed. Conclusion. Number of envenomation by cnidarians appears relatively low in New Caledonia, despite a recent increase in the number of cases involving a jellyfish. Scyphozoan envenomations, for the most part are not severe, allowing to consider an outpatient treatment. Therefore, cases implying a Physalia or a coral needs a transfer to hospital.
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Master Thesis
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Clara Margo. Les envenimations par cnidaires en Nouvelle-Calédonie, étude rétrospective entre 2005 à 2017 au Centre Hospitalier Territorial de Nouméa. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02142388⟩

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