DOCSLIB.ORG

The Bug Beneath the Bathing Suit: a Case Report and Discussion of Seabather’S Eruption Versus Cutaneous Larva Migrans

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Bug Beneath the Bathing Suit: a Case Report and Discussion of Seabather’S Eruption Versus Cutaneous Larva Migrans The bug beneath the bathing suit: A case report and discussion of seabather’s eruption versus cutaneous larva migrans Andrew Jensen, BS,* Marcus Goodman, DO, FAOCD** *Medical Student, 4th year, Philadelphia College of Osteopathic Medicine - Georgia Campus, Suwanee, GA **Dermatology Residency Program Director, PCOM/North Fulton Hospital Medical Campus, Roswell, GA Abstract Seabather’s eruption is an important differential diagnosis when a patient who has recently swum in a subtropical ocean presents with a pruritic rash in the distribution of their swimwear. Treatment with systemic corticosteroids is indicated in severe cases and can successfully reduce symptoms. Oral steroid therapy in general has proven to be an effective treatment for many acute and chronic diseases but has long been associated with increased risk for infections. In this report, we present an atypical case of cutaneous larva migrans and discuss its clinical unmasking after systemic steroid treatment was given for an initial diagnosis of seabather’s eruption. Introduction Case Report Figure 2 Seabather’s eruption is a benign, superficial A 52-year-old female presented to her reaction to toxins from marine-animal larvae. dermatologist complaining of an itchy rash on It is the most common marine-related problem her groin and upper leg for one week. The patient in the waters south of the United States.1 stated she recently traveled to Mexico, where she It was reported in Florida as early as 1903 spent several days on the beach and swimming in as a “rash which set up an intense itching” the ocean. Physical exam revealed erythematous, shortly after bathing in ocean water.2 In 1949, edematous papules on her lower abdomen and Sams postulated the eruption was caused by groin, assuming a location directly beneath her “some living, microorganism, in the nature of swimsuit (Figure 1). A biopsy was collected, nematocysts from some form of coelenterate and the patient was discharged with a topical which is free floating.”3 Substantiating Sams’ corticosteroid and antihistamine regimen. initial claim, the thimble jellyfish, Linuche Figure 3 unguiculata, is now thought to be the cause of Figure 1 seabather’s eruption in the southeastern United States, Mexico and the Caribbean.4 The skin reaction occurs when jellyfish stinging cells called nematocysts get trapped underneath swimwear and inject venom there, causing an immune response and succeeding rash. The condition is often exacerbated with persistent use of the contaminated swimwear, causing friction on nematocysts, or when the swimmer later bathes in fresh water, inducing osmotic irritation and Figure 4 subsequent envenomation.5 Less than 24 hours after the initial visit, the Seabather’s eruption is diagnosed clinically as a patient called the office complaining she constant, pruritic and erythematous rash, papular, could not tolerate the constant itch. She was macular or urticarial, most commonly located prescribed a methylprednisolone dose pack and underneath swimwear. Differential diagnoses was encouraged to follow up with the office in include animal schistosomiasis (swimmer’s four to five days or earlier if symptoms worsen. itch), scabies, insect bites, varicella zoster, Biopsy results were received (Figures 2 and 3) and contact dermatitis, folliculitis and almost any revealed a “papular urticaria/arthropod assault” marine-origin dermatosis. A skin biopsy is not consistent with an initial clinical diagnosis of required for diagnosis of seabather’s eruption seabather’s eruption. but most commonly shows a superficial and deep Five days after the initial visit, the patient perivascular and interstitial infiltrate consisting returned for follow-up stating the rash was Discussion of lymphocytes, neutrophils, and eosinophils.6 spreading. Physical exam showed a worsening of Corticosteroids and immune function The syndrome is not considered contagious and symptoms with urticarial papules and serpiginous Corticosteroids play a critical role in treating is self-limiting, usually lasting an average of three plaques radiating from the initial site (Figure 4). common diseases like rheumatoid arthritis, to seven days. Treatment of seabather’s eruption The patient was diagnosed with cutaneous larva chronic obstructive pulmonary disease and a host consists mainly of supportive therapy with topical migrans. She was instructed to discontinue the of mild-to-severe inflammatory disorders. Since corticosteroids and antihistamines, with systemic oral steroid and was given a single dose of 12 mg their advent in the late 1940s, both short- and steroid use reserved for severe cases. oral ivermectin. One week after treatment, the long-term use of oral corticosteroid therapy has patient’s rash was resolved. Page 38 THE BUG BENEATH THE BATHING SUIT: A CASE REPORT AND DISCUSSION OF SEABATHER’S ERUPTION VERSUS CUTANEOUS LARVA MIGRANS been associated with increased risk of infections.7 Skin biopsy is not recommended for diagnosis of 9. Klein NC, Go CH, Cunha BA. Infections The mechanism of action of these biologically CLM, as larvae advance ahead of the visible tracks, associated with Steroid Use. Infect Dis Clin of active steroid hormones is spread across the usually resulting in a negative biopsy. Eosinophilia North Am. 2001 Jun;15(2):423-4. entire immunological-response spectrum. is present in only 30% of cases, proving this test 12 10. Cronin L, Cook DJ, Carlet J. Corticosteroid Lionakis reported that glucocorticoids affect to be inadequate as a diagnostic study. First- treatment for sepsis: A critical reappraisal and virtually every cell type involved in immunity line treatments of CLM include oral ivermectin 8 meta-analysis of the literature. Crit Care Med. and inflammation. Klein observed that a single and albendazole. Caumes reported that a single 1995 Aug;23(8):1430-9. dose of corticosteroids caused neutrophilic 12 mg oral dose of ivermectin achieved a cure leukocytosis, monocytopenia, and eosinopenia rate of 81% to 100%, and a single 400 mg oral 11. Caumes E. Treatment of cutaneous larva within four to six hours of dosing.9 These and dose of albendazole achieved a cure rate of 46% migrans. Clin Infect Dis. 2000 May;30(5):811-4. 11 other reports have shown that steroid therapy is to 100%. Oral steroids are generally avoided in 12. Jackson A, Heukelbach J, Calheiros CM, associated with decreased migration of neutrophils parasitic or other occult infections due to their Soares VL, Harms G, Feldmeier H. A study to target tissues, a reduction of inflammatory immunosuppressing effects. in a community in Brazil in which cutaneous cytokines, and an inhibition of hydrogen peroxide larva migrans is endemic. Clin Infect Dis. 2006 8-10 production in lysosomes. Together, these Conclusion Jul;43(2):13-8. inhibitions decrease microorganism killing and As discussed in this case report, we submit 13. Hochedez P, Caumes E. Hookworm-related subsequent infection elimination. that our patient had an atypical presentation of cutaneous larva migrans most likely from lying cutaneous larva migrans. J Travel Med. 2007 Cutaneous larva migrans on a sandy beach contaminated with dog feces. Oct;14(5):326-33. Cutaneous larva migrans (CLM), or creeping With the original erythematous, papular rash 14. Heukelbach J, Feldmeier H. Epidemiological eruption, is the most common skin disease among appearing directly beneath the patient’s swimwear and clinical characteristics of hookworm-related travelers returning from tropical destinations.11 and the absence of any cutaneous tracks, cutaneous larva migrans. Lancet Infect Dis. 2008 CLM is caused by a penetrating parasite, most seabather’s eruption was initially diagnosed. Not May;8(5):302-9. commonly the Ancylostoma braziliense, which until treatment of a severely pruritic eruption flourishes in the gastrointestinal tracts of cats and with an oral steroid regimen did identifiable dogs. Commonly found along tropical beaches serpiginous and linear tracks appear, warranting Correspondence: Marcus Goodman, DO; where animal feces gets deposited, parasite larvae a modification of the clinical diagnosis and [email protected] can remain viable and infectious for months in 12 treatment. Once therapy was changed to an a warm and humid environment. With 95% of indicated treatment of cutaneous larva migrans, patients with CLM reporting recent exposure to the patient’s symptoms resolved. a beach, prevention is focused on limiting contact with feces-contaminated sand or soil.1 The best References suggested community prevention of CLM 1. Habif TP. Clinical Dermatology. 5th ed. has been to ban dogs from beaches, a difficult Amsterdam: Elsevier Academic Press; 2010. 625, task especially in developing countries. More 628-30 p. individual forms of prevention include wearing 2. Russell MT, Tomchik RS. Seabather’s eruption, shoes while walking, and lying on a mattress or or ‘sea lice’: new findings and clinical implications. sand washed with the ocean tide when touring a J Emerg Nurs. 1993 Jun;19(3):197-201. beach frequented by dogs. 3. Sams WM. Seabather’s eruption. Arch Derm. In a human host, larvae migration is confined 1949 Aug;60(2):227-37. within the epidermis, causing the classic presentation of incessantly pruritic, erythematous, 4. Burnett JW, Kumar S, Malecki JM. The edematous, serpiginous tracks.13 The irregular antibody response in seabather’s eruption. track pattern advances at an average rate of 2.7 Toxicon. 1995 Jan;33(1):99-104. millimeters per day and can often be used to 5. Ubillos SS, Vuong D, Sinnott JT, Sakalosky 12 estimate infection duration. CLM is diagnosed PE. Seabather’s Eruption. South Med J. 1995 clinically by recognition of these raised, red- Nov;88(11):1163-5. purple, linear or serpiginous tracks, which usually 6. Wong DE, Meinking TL, Rosen LB, Taplin occur along the feet. Other common sites of D, Hogan DJ, Burnett JW. Seabather’s eruption. involvement include the buttocks, thighs, elbows, Clinical, histologic, and immunologic features. J back and face. Am Acad Dermatol. 1994 Mar;30(3):399-406. For many clinicians, the disease may mimic 7. Dixon WG, Abrahamowicz M, Beauchamp scabies, schistosomiasis, tinea corporis, ME, et al. Immediate and delayed impact of oral or contact dermatitis.
Load more

Recommended publications
  • Marine Envenomations
    Environmental Marine envenomations Ingrid Berling Geoffrey Isbister Background The majority of marine envenomings are minor and do Marine stings are common but most are minor and do not not require medical intervention. Jellyfish stings are a require medical intervention. Severe and systemic marine frequent reason for presentation to first aid and primary envenoming is uncommon, but includes box jellyfish stings, healthcare providers. A knowledge of the variety of stings Irukandji syndrome, major stingray trauma and blue-ringed and envenoming syndromes that occur in Australia, octopus envenoming. Almost all marine injuries are caused including those that are clinically significant, and available by jellyfish stings, and penetrating injuries from spiny fish, treatments, is necessary for practitioners, particularly those stingrays or sea urchins. working in coastal regions. Objective This article describes the presentation and management Marine envenoming can be considered in two broad categories: of marine envenomations and injuries that may occur in jellyfish stings and penetrating venomous marine injuries. Jellyfish Australia. stings range from the life-threatening major box jellyfish (Chironex Discussion fleckeri) to painful, but generally benign, bluebottle stings common First aid for jellyfish includes tentacle removal, application to most southeastern Australian beaches (Figure 1). Penetrating of vinegar for box jellyfish, and hot water immersion (45°C venomous marine injuries often occur when handling fish, but can for 20 min) for bluebottle jellyfish stings. Basic life support occur to anyone involved in water activities, fresh water or marine. is essential for severe marine envenomings that result in They are typically more painful than just the trauma of the wound, and cardiac collapse or paralysis.
    [Show full text]
  • Traveler Information
    Traveler Information QUICK LINKS Marine Hazards—TRAVELER INFORMATION • Introduction • Risk • Hazards of the Beach • Animals that Bite or Wound • Animals that Envenomate • Animals that are Poisonous to Eat • General Prevention Strategies Traveler Information MARINE HAZARDS INTRODUCTION Coastal waters around the world can be dangerous. Swimming, diving, snorkeling, wading, fishing, and beachcombing can pose hazards for the unwary marine visitor. The seas contain animals and plants that can bite, wound, or deliver venom or toxin with fangs, barbs, spines, or stinging cells. Injuries from stony coral and sea urchins and stings from jellyfish, fire coral, and sea anemones are common. Drowning can be caused by tides, strong currents, or rip tides; shark attacks; envenomation (e.g., box jellyfish, cone snails, blue-ringed octopus); or overconsumption of alcohol. Eating some types of potentially toxic fish and seafood may increase risk for seafood poisoning. RISK Risk depends on the type and location of activity, as well as the time of year, winds, currents, water temperature, and the prevalence of dangerous marine animals nearby. In general, tropical seas (especially the western Pacific Ocean) are more dangerous than temperate seas for the risk of injury and envenomation, which are common among seaside vacationers, snorkelers, swimmers, and scuba divers. Jellyfish stings are most common in warm oceans during the warmer months. The reef and the sandy sea bottom conceal many creatures with poisonous spines. The highly dangerous blue-ringed octopus and cone shells are found in rocky pools along the shore. Sea anemones and sea urchins are widely dispersed. Sea snakes are highly venomous but rarely bite.
    [Show full text]
  • The Polyp and the Medusa Life on the Move
    The Polyp and the Medusa Life on the Move Millions of years ago, unlikely pioneers sparked a revolution. Cnidarians set animal life in motion. So much of what we take for granted today began with Cnidarians. FROM SHAPE OF LIFE The Polyp and the Medusa Life on the Move Take a moment to follow these instructions: Raise your right hand in front of your eyes. Make a fist. Make the peace sign with your first and second fingers. Make a fist again. Open your hand. Read the next paragraph. What you just did was exhibit a trait we associate with all animals, a trait called, quite simply, movement. And not only did you just move your hand, but you moved it after passing the idea of movement through your brain and nerve cells to command the muscles in your hand to obey. To do this, your body needs muscles to move and nerves to transmit and coordinate movement, whether voluntary or involuntary. The bit of business involved in making fists and peace signs is pretty complex behavior, but it pales by comparison with the suites of thought and movement associated with throwing a curve ball, walking, swimming, dancing, breathing, landing an airplane, running down prey, or fleeing a predator. But whether by thought or instinct, you and all animals except sponges have the ability to move and to carry out complex sequences of movement called behavior. In fact, movement is such a basic part of being an animal that we tend to define animalness as having the ability to move and behave.
    [Show full text]
  • Marine Mammals and Sea Turtles of the Mediterranean and Black Seas
    Marine mammals and sea turtles of the Mediterranean and Black Seas MEDITERRANEAN AND BLACK SEA BASINS Main seas, straits and gulfs in the Mediterranean and Black Sea basins, together with locations mentioned in the text for the distribution of marine mammals and sea turtles Ukraine Russia SEA OF AZOV Kerch Strait Crimea Romania Georgia Slovenia France Croatia BLACK SEA Bosnia & Herzegovina Bulgaria Monaco Bosphorus LIGURIAN SEA Montenegro Strait Pelagos Sanctuary Gulf of Italy Lion ADRIATIC SEA Albania Corsica Drini Bay Spain Dardanelles Strait Greece BALEARIC SEA Turkey Sardinia Algerian- TYRRHENIAN SEA AEGEAN SEA Balearic Islands Provençal IONIAN SEA Syria Basin Strait of Sicily Cyprus Strait of Sicily Gibraltar ALBORAN SEA Hellenic Trench Lebanon Tunisia Malta LEVANTINE SEA Israel Algeria West Morocco Bank Tunisian Plateau/Gulf of SirteMEDITERRANEAN SEA Gaza Strip Jordan Suez Canal Egypt Gulf of Sirte Libya RED SEA Marine mammals and sea turtles of the Mediterranean and Black Seas Compiled by María del Mar Otero and Michela Conigliaro The designation of geographical entities in this book, and the presentation of the material, do not imply the expression of any opinion whatsoever on the part of IUCN concerning the legal status of any country, territory, or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The views expressed in this publication do not necessarily reflect those of IUCN. Published by Compiled by María del Mar Otero IUCN Centre for Mediterranean Cooperation, Spain © IUCN, Gland, Switzerland, and Malaga, Spain Michela Conigliaro IUCN Centre for Mediterranean Cooperation, Spain Copyright © 2012 International Union for Conservation of Nature and Natural Resources With the support of Catherine Numa IUCN Centre for Mediterranean Cooperation, Spain Annabelle Cuttelod IUCN Species Programme, United Kingdom Reproduction of this publication for educational or other non-commercial purposes is authorized without prior written permission from the copyright holder provided the sources are fully acknowledged.
    [Show full text]
  • Population Structures and Levels of Connectivity for Scyphozoan and Cubozoan Jellyfish
    diversity Review Population Structures and Levels of Connectivity for Scyphozoan and Cubozoan Jellyfish Michael J. Kingsford * , Jodie A. Schlaefer and Scott J. Morrissey Marine Biology and Aquaculture, College of Science and Engineering and ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville, QLD 4811, Australia; [email protected] (J.A.S.); [email protected] (S.J.M.) * Correspondence: [email protected] Abstract: Understanding the hierarchy of populations from the scale of metapopulations to mesopop- ulations and member local populations is fundamental to understanding the population dynamics of any species. Jellyfish by definition are planktonic and it would be assumed that connectivity would be high among local populations, and that populations would minimally vary in both ecological and genetic clade-level differences over broad spatial scales (i.e., hundreds to thousands of km). Although data exists on the connectivity of scyphozoan jellyfish, there are few data on cubozoans. Cubozoans are capable swimmers and have more complex and sophisticated visual abilities than scyphozoans. We predict, therefore, that cubozoans have the potential to have finer spatial scale differences in population structure than their relatives, the scyphozoans. Here we review the data available on the population structures of scyphozoans and what is known about cubozoans. The evidence from realized connectivity and estimates of potential connectivity for scyphozoans indicates the following. Some jellyfish taxa have a large metapopulation and very large stocks (>1000 s of km), while others have clade-level differences on the scale of tens of km. Data on distributions, genetics of medusa and Citation: Kingsford, M.J.; Schlaefer, polyps, statolith shape, elemental chemistry of statoliths and biophysical modelling of connectivity J.A.; Morrissey, S.J.
    [Show full text]
  • A Guide to Harmful and Toxic Creatures in the Goa of Jordan
    Published by the Royal Marine Conservation Society of Jordan. P. O. Box 831051, Abdel Aziz El Thaalbi St., Shmesani 11183. Amman Copyright: © The Royal Marine Conservation Society of Jordan Reproduction of this publication for educational and other non- commercial purposes is authorized without prior written approval from the copyright holder provided the source is fully acknowledged. ISBN: 978-9957-8740-1-8 Deposit Number at the National Library: 2619/6/2016 Citation: Eid, E and Al Tawaha, M. (2016). A Guide to Harmful and Toxic Creature in the Gulf of Aqaba of Jordan. The Royal Marine Conservation Society of Jordan. ISBN: 978-9957-8740-1-8. Pp 84. Material was reviewed by Dr Nidal Al Oran, International Research Center for Water, Environment and Energy\ Al Balqa’ Applied University,and Dr. Omar Attum from Indiana University Southeast at the United State of America. Cover page: Vlad61; Shutterstock Library All photographs used in this publication remain the property of the original copyright holder, and it should not be reproduced or used in other contexts without permission. 1 Content Index of Creatures Described in this Guide ......................................................... 5 Preface ................................................................................................................ 6 Part One: Introduction ......................................................................................... 8 1.1 The Gulf of Aqaba; Jordan ......................................................................... 8 1.2 Aqaba;
    [Show full text]
  • Our Summer Newsletter Has Gone to the Dogs!
    Summer 2013 Newsletter Our summer newsletter has gone to the dogs! In this issue… Pet-Friendly Rentals | Tips for taking your dog to the beach | Beach essentials equipment list | Area vets and boarding | OIB doggy photos | What’s new? and more. There are huge benefits when you travel with your pet. No boarding fees is just one, but there's also no anxiety about how your pet is coping while you're away, less separation stress for your pet, more spacious accommodations that will be just like they're used to at home, and a fun-filled vacation that includes your pet being included with the family. Whether you're a family taking a summer vacation or snowbirds coming south for the winter, you'll be comfortable knowing your pet is welcome here too and that we have a variety of pet friendly rentals to choose from. OCEANFRONT HOUSES 358 East First Street…4 bedroom…$2195 434 East Second St….3 bedroom…$2195 SECOND ROW HOUSES 93 East First Street…..3 bedroom….$965 119 East First Street….4 bedroom…$915 345 East First Street…6 bedroom…$4015 THIRD ROW HOUSES 78 East Second Street..4 bedroom…$995 MID-ISLAND HOUSES 2 Driftwood Street…...2 bedroom…$995 CANAL HOUSES 1 Concord Street……4 bedroom…$1145 41 Concord Street…...4 bedroom…$1315 69 Fairmont Street……4 bedroom…$995 44 Leland Street….…5 bedroom…$1460 26 Wilmington St……6 bedroom…$1095 CONDOS Ocean Cove 105……..1 bedroom…$995 Ocean Cove 219……...1 bedroom…$995 Oceanside West F-1…..3 bedroom…$975 VIOLET, photo courtesy of Julie 1.
    [Show full text]
  • Whale Sharks of the Western Caribbean: an Overview of Current Research and Conservation Efforts and Future Needs for Effective Management of the Species
    Gulf and Caribbean Research Vol 19(2), 149–159, 2007 Manuscript received December 26, 2006; accepted May 11, 2007 WHALE SHARKS OF THE WESTERN CARIBBEAN: AN overview OF CURRENT RESEARCH AND conservation efforts AND FUTURE NEEDS FOR EFFECTIVE management OF THE SPECIES Rachel T. Graham Wildlife Conservation Society, PO Box 37, Punta Gorda, Belize, E-mail [email protected] ABSTRACT Whale sharks (Rhincodon typus) are seasonal visitors to four sites in the Western Caribbean, 3 of which are encompassed by the Mesoamerican Barrier Reef. Predictable encounters with the world’s largest fish have raised this species’ profile globally and led to several research and conservation efforts that aim to elucidate the need for information for the species management and balance the growing demand for highly lucrative encounter tour- ism. Tagging studies have demonstrated that the whale shark population is relatively small and likely forms a single population. Individuals move throughout the region between 3 of 4 known feeding sites and are capable of timing their movements to pulses of productivity. Whale shark tourism’s dramatic growth has led to a range of protective measures and scientific studies both precautionary and reactionary that require better harmonization throughout the region to be effective. This paper will provide an overview of the status of whale shark research and conservation efforts in the Western Caribbean and identify future management needs to minimize anthropogenic impacts and enable continued whale shark visitation at key feeding sites. RESUMEN Los tiburones ballenas son visitantes estaciónales a cuatro sitios en el Caribe occidental, tres de los cuales se ubican en el arrecife Mesoamericano.
    [Show full text]
  • Proceedings of the Twenty-Ninth Annual Symposium on Sea Turtle Biology and Conservation
    NOAA Technical Memorandum NMFS-SEFSC-630 PROCEEDINGS OF THE TWENTY-NINTH ANNUAL SYMPOSIUM ON SEA TURTLE BIOLOGY AND CONSERVATION 17 to 19 February 2009 Brisbane, Queensland, Australia Compiled by: Lisa Belskis, Mike Frick, Aliki Panagopoulou, ALan Rees, & Kris Williams U.S. DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration NOAA Fisheries Service Southeast Fisheries Science Center 75 Virginia Beach Drive Miami, Florida 33149 May 2012 NOAA Technical Memorandum NMFS-SEFSC-630 PROCEEDINGS OF THE TWENTY-NINTH ANNUAL SYMPOSIUM ON SEA TURTLE BIOLOGY AND CONSERVATION 17 to 19 February 2009 Brisbane, Queensland, Australia Compiled by: Lisa Belskis, Mike Frick, Aliki Panagopoulou, ALan Rees, Kris Williams U.S. DEPARTMENT OF COMMERCE John Bryson, Secretary NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION Dr. Jane Lubchenco, Under Secretary for Oceans and Atmosphere NATIONAL MARINE FISHERIES SERVICE Samuel Rauch III, Acting Assistant Administrator for Fisheries May 2012 This Technical Memorandum is used for documentation and timely communication of preliminary results, interim reports, or similar special-purpose information. Although the memoranda are not subject to complete formal review, editorial control or detailed editing, they are expected to reflect sound professional work. NOTICE The NOAA Fisheries Service (NMFS) does not approve, recommend or endorse any proprietary product or material mentioned in this publication. No references shall be made to NMFS, or to this publication furnished by NMFS, in any advertising or sales promotion which would indicate or imply that NMFS approves, recommends or endorses any proprietary product or material herein or which has as its purpose any intent to cause directly or indirectly the advertised product to be use or purchased because of NMFS promotion.
    [Show full text]
  • You're a Jellyfish!
    You’re a Jellyfish! LEVELED BOOK • O A Reading A–Z Level O Leveled Book Word Count: 718 Written by Kira Freed • Illustrated by Cende Hill Visit www.readinga-z.com www.readinga-z.com for thousands of books and materials. Photo Credits: Front cover: © Randy Olson/National Geographic Image Collection; back cover: © Ingo Arndt/Minden Pictures/National Geographic Stock; title page: © iStock.com/ Robert Weber; page 3: © Jupiterimages Corporation; page 4: © Kyodo/Newscom; page 5: © Mariusz Jurgielewicz/123RF; page 7 (main): © Stuart Westmorland/Corbis Documentary/Getty Images; page 7 (inset): © Ken Lucas/Visuals Unlimited/Getty Images; page 9: © iStock.com/Richard McMillin; page 11 (left): © Paul Sutherland/ National Geographic Stock; page 11 (top right, bottom right): © David Doubilet/National Geographic Stock; page 12: © ullstein bild/Getty Images; page 13: © Brian Cassey/ AP Images; page 14 (background): © iStock.com/10four design group; page 14 (main): Caroline Hall/Alamy; page 15: © NOAA/Monterey Bay Aquarium Research Institute You’re a Jellyfish! Level O Leveled Book © Learning A–Z Correlation Written by Kira Freed LEVEL O Written by Kira Freed Illustrated by Cende Hill Illustrated by Cende Hill Fountas & Pinnell M All rights reserved. Reading Recovery 20 www.readinga-z.com www.readinga-z.com DRA 28 Table of Contents This is a lion’s mane jellyfish. Floating at Sea . 4 Floating at Sea Jelly Bodies . 6 Imagine that your body is shaped like Getting Around . 8 a bell, and you have long tentacles Life Cycle . 10 streaming down under you . You are Hunter and Hunted . 11 mostly made of water and cannot survive away from it .
    [Show full text]
  • 2014 What-To-Do-In-A-Medical-Emerg
    What To Do in a Medical Emergency MEDICAL EMERGENCIES WHAT YOU NEED TO KNOW FROM AMERICA’S EMEGENCY PHYSICIANS www.EmergencyCareForYou.org What To Do in a Medical Emergency At what point does a fever or stomach ache become a med- ical emergency? If you slice your finger with a knife, or you are having the worst headache you’ve ever had, should you seek emergency care? How do you know? The following information from the nation's emergency physicians will help you identify the signs and symptoms of emergency conditions. However, emergency physicians will tell you — if you think you are having a medical emer- gency, seek emergency care right away. Better safe, than sorry. Too many people, such as men with chest pain, wait too long to seek care. The advice in this publication is about how to handle com- mon emergency medical conditions. It does not contain all the signs or symptoms of medical emergencies, and the advice is not intended to be a substitute for consulting with a medical professional. If you think you are experiencing a medical emergency, seek immediate medical attention. www.EmergencyCareForYou.org 2 TABLE OF CONTENTS Contents Abdominal Pain ..............................................................................................4 Asthma and Allergies.....................................................................................4 Anaphylaxis.....................................................................................................8 Adverse Drug Reactions ................................................................................9
    [Show full text]
  • JELLYFISH STINGS: COMPLICATIONS and MANAGEMENT by TOSSON A
    Journal of the Egyptian Society of Parasitology, Vol.50, No.2, August 2020 J. Egypt. Soc. Parasitol. (JESP), 50(2), 2020: 270 - 280 JELLYFISH STINGS: COMPLICATIONS AND MANAGEMENT By TOSSON A. MORSY1*, NAHLA M. SHOUKRY2** and MAHMOUD A. FOUAD3*** Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo 115661 Department of Zoology, Faculty of Science, Suez University, Suez2, Egypt, and Department of Medical Parasitology and Microbiology, Faculty of Medicine, King Abdulaziz University, Jeddah3, Saudi Arabia (Correspondence: *tossonmorsy@ med.asu.edu.eg or [email protected], orcid.org/0000-0003-2799-2049, **[email protected] & ***[email protected]) Abstract Jellyfish and sea jellies are the informal common names given to the medusa-phase of certain gelatinous members of subphylum Medusozoa, the majority of phylum Cnidaria. Jellyfish are mainly free-swimming marine animals with umbrella-shaped bells and trailing tentacles, alt- hough a few are not mobile, being anchored to the seabed by stalks. The bell can pulsate to give propulsion and highly efficient locomotion. Tentacles are armed with stinging cells and may be used to capture prey and defend against predators. Jellyfish have a complex life cycle; the medu- sa is normally the sexual phase, the planula larva can disperse widely and is followed by a sed- entary polyp phase. Jellyfish are found worldwide, from surface waters to the deep sea. Scyphozoans ("true jelly- fish") are exclusively marine, but some hydrozoans with a similar appearance live in freshwater. Large, often colorful, jellyfish are common in coastal zones worldwide. The medusae of most species are fast growing, mature within a few months and die soon after breeding, but the polyp stage, attached to the seabed, may be much more long-lived.
    [Show full text]