Kategorie: News
A small scratch and drastic consequences
A small scratch from a fire coral can quickly have severe consequences, as the report of an affected diver strikingly shows. What started as a harmless contact led to a months-long ordeal. Find out which first-aid measures really help and how important the right treatment of such injuries is.
Report of the accident from the perspective of our user Reinhard:
In August 2023, I spent my diving holiday in Soma Bay, Egypt. It was a dream holiday – until the one dive that changed everything. During a dive, I was pushed by a current towards a coral reef. In an attempt to catch myself, I touched a fire coral and scraped my left leg four times. At that point, I had no idea what dramatic consequences these seemingly harmless injuries would have.
I treated the scratches immediately after the dive with acetic acid, as I always do in such cases. The fire coral releases a strong nettle toxin that initially causes burning pain but subsides relatively quickly. This can easily lead to underestimating the injury. Unfortunately, I overlooked a scratch on my calf, which later turned out to be disastrous.
The first escalation
Two days later, while showering, I discovered a blister on my calf. Although I reacted immediately with a vinegar solution and a bandage, the situation quickly worsened. By the next day, my departure day, the blister had developed into an open wound the size of a 10-cent piece. The hotel medic treated the injury with an iodine bandage, and I began my journey home.
When I arrived in Frankfurt, I noticed the next day that the wound had increased to the size of a golf ball. Severe pain and fever made things even worse. The emergency doctor I saw was overwhelmed and merely re-dressed the wound without making an accurate diagnosis. The next day, the fever had gone, but I decided to see a general practitioner, who immediately referred me to a trauma surgeon.
Necrosis and further complications
The emergency surgeon identified the dark edges of the wound as necrosis – dead tissue that had formed due to the effects of the nettle venom. The three-week treatment with ointment dressings, which were changed every three days, initially appeared to be successful. The wound healed slowly, and I was hopeful that everything would turn out well.
But after another week, on a Sunday morning, I suddenly woke up with severe pain, fever and circulatory problems. When I removed the bandage, I discovered that another large opening in the skin had formed overnight. My wife and I immediately went to the emergency room at the University Hospital in Frankfurt, where the doctors said the original wound was healing well, but attributed the new injuries to a new infection.
Further examinations, dressings and swabs followed, but these did not provide any clear results. Meanwhile, my condition continued to deteriorate. Not wanting to rely on the doctors alone, I sought additional advice. I phoned tropical and marine institutes all over Germany – but no one could really help me.
The decisive breakthrough
In my desperation, I finally turned to the Poisons Information Centre in Mainz. A very friendly lady there passed my case on to a doctor who was a scuba diver himself. This call back was the turning point in my story. The doctor explained to me that it was of the utmost importance to have the necroses removed surgically, as there could still be active nettle cells underneath. These cells could continue to secrete venom with every mechanical irritation, which could lead to renewed poisoning.
He also recommended that another smear be taken because of the possibility that bacteria from Egyptian tap water had infected the wound. In fact, the hospital staff in Frankfurt found four strains of bacteria that could be traced back to the Egyptian water. The prescribed antibiotic was adjusted, and the wound, which had now reached the size of a tennis ball, was treated in four operations with vacuum dressings and skin grafts.
After a total of four months, the injury had finally healed. The healing process was long and painful, but the combination of nettle venom and bacterial infection made this one of the most complex injuries I have ever encountered.
Statement from our doctor
Dr Silke Schwaner from the Druckkammerzentrum Heidelberg explains that nettle injuries caused by fire corals are among the most common diving accidents in tropical waters. These coral species can be found in shallow areas of reefs and can easily be mistaken for harmless stony corals. Divers should ensure that they have careful buoyancy control and always keep a sufficient distance from coral reefs.
The venom of the fire coral has a haemolytic and necrotising effect, which means that it damages blood cells and causes tissue to die off. Contact causes immediate pain, but this quickly subsides, which can lead to the injury being underestimated. First aid measures include washing the affected areas with seawater, applying 5% acetic acid and cleaning with sterile fresh water.
If the wound shows any sign of infection, a doctor should be consulted immediately and a wound swab taken. The risk of superinfection by germs present in the environment should not be underestimated. Dr Schwaner also emphasises that European doctors often have little experience with such injuries, which is why it is advisable to point out to them the potential for contact with cnidarians.
Conclusion
This case is a striking example of how dangerous contact with fire corals can be, especially if the injury is not recognised immediately or is treated incorrectly. The combination of the venom of the nettle and bacterial infections can lead to serious complications in healing. Fast, targeted treatment is vital. It is crucial to avoid contact with corals, and if an injury occurs, the right medical care should be sought immediately.
Useful information can also be found on the AquaMed website:
www.aqua-med.eu/training/...10_gefaehrliche_wasserorganismen.pdf