Blue-ringed octopus (Hapalochlaena sp.) envenomation of a 4-year-old boy:: A case report

Introduction. The blue-ringed octopus (Hapalochlaena sp.) is a small animal, which can inject a toxin that produces a respiratory arrest within minutes. This envenomation is a rare occurrence with very few reported outcomes in children. Case report. A 4-year-old boy was bitten by a blue-ringed octopus (Hapalochlaena sp.) whilst playing at a popular beach in Queensland, Australia. Within ten minutes of the bite, he had vomited three times, lost the ability to stand and complained of blurred vision. An ambulance was called by the time he presented to the local emergency department (20 minutes after the bite) he had acute and progressive skeletal muscle weakness. He was intubated, ventilated, and transferred to a pediatric intensive care unit for specialized supportive care. He was ventilated for a total of 17 hours with spontaneous muscular activity returning at around 15 hours from envenomation. Discussion. If not treated appropriately the bite of this small and innocuous looking animal could have lead to death within minutes. Conclusion. This case report serves as a reminder of how appropriate treatment can ensure discharge from hospital with no long-term consequences. It also highlights the importance of education for beach goers and in particular parents to prevent exposure of tetrodotoxin to children.