Clinical presentation of Irukandji syndrome

Irukandji syndrome is characterised by initial minor local effects, but the sting site is not usually visible. After 20 to 30 minutes, effects may include:

• severe generalised pain—back, abdomen, chest and muscles
• tachycardia and hypertension
• nausea and vomiting
• anxiety and agitation.

In severe cases, cardiac effects can occur, including:

• changes on electrocardiogram (ECG)—T wave inversion and ST segment depression
• myocardial depression
• raised serum troponin concentration
• cardiogenic pulmonary oedema
• cardiogenic shock.