Lionfish, Scorpionfish, And Stonefish Toxicity

Venomous fish are a threat to divers across the world. In fact, more than 50% of venomous vertebrates are fish. The family Scorpaenidae includes the most venomous fish in the ocean and, next to the stingray, are responsible for the most marine envenomations annually. [1][2][3]The family is subclassified by the morphology of the venomous spines of the fish into 3 major subfamilies, the lionfish, scorpionfish, and stonefish. All of these fish possess spines on their dorsal, pelvic, and anal fins. These spines are encapsulated by glandular venom-producing integumentary sheaths that release venom when mechanically disrupted through contact with a victim. Lionfish are common residents of aquariums and typically injure the fingers and hands of those who handle the fish. Scorpionfish are commonly encountered by divers or fishermen and often injure the hands of those who touch them. Stonefish are bottom-feeders that cause injury when they are stepped on, commonly in the coastal waters of Australia, Indonesia, and India. Understanding the distribution of these fish, their appearance, the injuries they cause, and management is important for physicians and patients at risk.