Clinical presentation of major box jellyfish stings

Effects of major box jellyfish stings include:

• local effects
  • severe local pain
  • erythematous wheal; papular urticarial rash over the sting site can occur in 7 to 14 days
  • superficial necrosis with more severe stings (rarely results in permanent scarring)
• systemic effects due to severe envenoming
  • cardiovascular collapse (eg hypotension, cardiac arrest, unconsciousness, seizures)
  • death within 20 to 30 minutes.