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Stingray bite and Multiple Sclerosis
In January 2005, my wife was stung by a stingray (similar sea creature) on the right thigh.  Three months later, she began to get numb toes on her right foot ans started to struggle with chronic fatigue.  Now 2 and half years later, she needs about 12 hours of sleep per day (yet still feels tired), has the numb toe as well as a sore patch on her lower right arm.  In that time, she has visited a neurologist a few times, had an MRI scan done (which was inconclusive), and spent much time with her family doctor, tired several different diet ideas, and is now seeing a natural path.  Any thoughts on whether or not the sting ray has anything to do with her chronic fatigue?
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147426 tn?1317269232
You ask an interesting question.  My first question is, in what way was the MRI "inconclusive?"  Do you have the entire report and would you be willing to share it?

First, let me preface my answer with making sure you know that what I am saying is pure supposition, based on some clinical experiences.  I spent 3 years in the Indian Health Service in Yuma, AZ and in Nevada.  I treated a large number of venomous bites and stings, specifically rattlesnake, scorpion and black widow spider.  Venom is a protein, for the most part, and it is a potent stimulator of the immune system.  So is anti-venom.

In several cases I had patients respond to their envenomations with delayed hypersensitivity reactions.  The most common was serum sickness.  This occurred in every snake bite victim who got antivenom.  But it also occurred in victims of a scorpion sting and a black widow bite who did not receive antivenom.

Serum sickness is a systemic response about 2 weeks after the sting/bite that involves fever, hives and flushing, diffuse and often severely painful joints.  Sometimes the joints actually do swell and become red, diffuse muscle pain and headache.  It's like influenza with hives (pretty miserable)  and it's treated with steroids for a couple weeks.  The syndrome can recur weeks and months later.

The only reason I tell you this is to demonstrate that venom can throw the immune system into overload and result in real suffering.  You are on an MS site and I have never read or heard of MS being attributable to an envenomation.  But, from what you have told us, it isn't clear that your wife has or doesn't have MS.  And I would have to know the mechanism by which the sea creature does it's damage.  It's really not my field of knowledge.

But, it is possible that your wife has Chronic Fatigue and Immune Dysfunction which is currently the preferred name for CFS.  It is felt to caused by some insult which has dysregulated the immune system, and immune abnormalities are associated with CFIDS.

Of course, it is also possible that the chronic fatigue and neurological symptoms that your wife has are not related to the stingray incident.

She needs to be fully evaluated for this kind of incapacitating fatigue - which I know all too intimately.  I need a minimum of 10 hours per night, usually get 12 and sometimes 16 and rarely feel rested.  Has she had a sleep study?  She should have one.  And I would recommend that she be evaluated by an academic Immunologist.  These doctors are similar to Rheumatologists and treat many of the same illnesses, but they also delve more deeply into the specific immune function.  You find them at university medical centers.

I'm sure you've read extensively about  chronic fatigue and understand that it's cause(s) are not well understood nor are the treatments often very effective, but a thorough search for a treatable cause is very important.  This would include infections, neuro diseases, autimmune diseases and endocrine abnormalities, especially thyroid.

But, I was tantalized by the possible association with the venom of the stingray and by my experience with people's immune problems immediately afterward.  By the way, I wasn't in a position to know if any of those patients had problems with fatigue or their immune systems further on in time.

I would still like to hear about this "inconclusive" MRI, and when the plans are to repeat it.

Quix
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147426 tn?1317269232
I implied that I didn't think this was MS.  I can't say one way or the other.  I could certainly imagine that the venom and an immune reaction to it in a susceptible person with other circumstances being right - could conceivably initiate MS.  There is good evidence for the role of an immune-stimulating infection in triggering MS, with the most well-documented (but not proven) one being Epstein Barr Virus.

Quix
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  Quix is dead on about venom and the reaction in the human body. I spent six years in South America and saw first hand the delayed effect a bite can have. I would not rule out the connection. But again, they could be unrelated.

Johnny
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286034 tn?1201100440
Just thought (since Stingrays are one of our islands biggest attractions) I'd post some information on Stingray venom as an FYI on this one;

"The 'sting' which gives these fishes their common name is a modified dermal denticle mounted near the base of the tail, about one-third along its total length. The sting consists of a blade-like barb with serrations along both edges and a venom gland at the base. The serrae point toward the base of the spine, making removal difficult and very painful. The venom is a fairly powerful nerve toxin which affects the heart in complex and dangerous ways. But like most fish toxins, stingray venom is a large protein that can be broken down by heat. First aid should begin with immersion of the wound in hot but non-scalding water (110 to 113° F) for 30 to 90 minutes. The wound should then be cleaned with soap and water and any broken bits of stingray spine should be removed; no attempt should be made to tape or sew the wound closed, unless necessary to stop excessive bleeding. If the wound shows signs of infection (redness, swelling, pus), administer antibiotics. Treatment by a physician is indicated in any stingray envenomation."


"A stingray's venom is not necessarily fatal, but it hurts a lot. It's composed of the enzymes 5-nucleotidase and phosphodiesterase and the neurotransmitter serotonin. Serotonin causes smooth muscle to severely contract, and it is this component that makes the venom so painful. The enzymes cause tissue and cell death. If the venom is introduced into an area like the ankle, it can usually be treated. Heat breaks down stingray venom and limits the amount of damage it can do."

As far as I know, and this is not a medical opinion by any means, but just from experience of living in the only place in the world that has a free water marine 'park' dedicated to stingrays...we've never had a case of a permanent reaction like what you've mentioned. At any case I think your wife's body should have broken the venom down a long time ago..

Just my two cents

Jolene
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147426 tn?1317269232
Wow!  Thanks!  I know  a lot more about stingrays.

The damage to the wife's immune system hypothetically would not be from the persistence of the venom, but to the immune reaction stimulated by exposure to it.  That immune activation would be what would persist and conceivably cause a reaction.

Q
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220917 tn?1309788081
I am going to skip my regular half hour of Discovery Channel tonight.  Thanks, you wonderful people!

Zilla*
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220917 tn?1309788081
You've found the right forum!  It's such an interesting question, and I hope your wife finds some relief and some answers.  

Good luck as we try our best to help you sort this all out!

Zilla*
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286034 tn?1201100440
Ahhhhh....I see now....that makes a lot more sense.....gracias!
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Thank you for taking the time to think this through!  Thanks also to Jolene for your thoughts on stingrays and to the others as well.  This is "the wife" :)

No I haven't had a sleep study done, although it seems when you are tired all the time, there just isn't time to investigate although it is necessary to get better...  The only change since October when this was posted is that I have been experiencing pain in my hands.  I have been in for tests related to that.  So far there is talk of arthritis although the test results are not back yet.

The MRI was done in 2005 and showed a spot in my brain, one on my pituitary and one on my spine.  The neurologist felt that the first one could just be a hole in my head (likely :) (lol) and the other two were too small to point with certainty to MS.  Although I have been back periodically, the recommendation has been to "come back if it gets worse" or if there are "changes".  I appreciate your insights, thank you.
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147426 tn?1317269232
I have learned more since we spoke in October.  I now believe that the venom of any poisonous creature could easily cause MS to manifest.  By this I mean that someone who had the right initial triggers and susceptibilities could have the MS show up at that time.  We know that the first manifestation of MS often occurs after something that has stimulated the immune system, infection, delivery of a baby (where the immune system ramps back up after being suupressed some during the pregnancy) and vaccinations.

So, a venomous bite or sting might set MS off - but would not be the actual cause.

Does this make sense?

Quix
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338416 tn?1420049302
[Whistling...]

I believe this to be absolutely true.  I have had sensory symptoms for years, but never thought anything of them.  Two years ago, I was bit by a brown recluse spider, and started having numbness, tingling, dizziness, and some other weird stuff.  Finally went to the doctor, who sent me to the neurologist, and now here I am.  I've heard of other people who've been injured and started having symptoms directly after, like the woman on another forum who stepped on a knitting needle.
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362692 tn?1248642793
Quix

Do you watch CSI?  You are now AKA Grisom. Love this post VERY informative!!

Rebeccah
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147426 tn?1317269232
Cool!!  Thank you!

Quix, AKA Grisom, AKA Momma Bear  :)
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405614 tn?1329147714
What an interesting and informative discussion!  I had to laugh at the CSI reference; I thought the same thing not long ago, that we are all CSIs trying to put together the clues that explain what is going on with our bodies!

To "the wife":

I wish you all the best; answers, feeling better, minimal new symptoms, and comfort and peace.  

Kathy
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In my case it was a total hip replacement that started my MS symptoms after 40 years of "quiet".  I think it was just lying in wait for the right trigger and susceptibility (Quix words) to  kick in. Unfortunatley it kicked in and attacked my own immune system instead of fighting it.  My Orthopedic surgeon absolutely agrees with this.

I was wondering if I had another hip replacement whether it would reverse this process - NOT!   Just kidding!


Marcie
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A few days ago I encountered 3 large stingrays coming towards me in a bay where the water was waist deep.  They came within 3 feet of me but within moments another one swam by and came back for a closer look.  My question is what is the best defense in dealing with an inquisitive stingray?

Thank You,
John
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338416 tn?1420049302
Typically stingrays are not aggressive.  I did a 'swim with the stingrays' outing when I was on a cruise, years ago.  They were quite friendly, and seemed mostly interested in the chum bucket.  Perhaps you smelled like fish?
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572651 tn?1333939396
Best tip -shuffle your feet when walking in the ocean water - the stingray don't like to be stepped on but otherwise are usually on-agressive.  Contact with them and their barb is usually accidental.

Lulu
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I found this post and site while researching the same thing. Just over a year ago my wife was stung on the top of her foot near the ankle by a sting ray in Anna Maria ISland Florida. Now she is having mri's blood work and seeing a neurologist trying to rule out MS and Lymphoma. She had an inconlusive mri as well and later this week will be getting a biopsy done on her lymphnodes. She has experienced chronic fatigue that is getting worse and her lymphnodes are constantly swollen as well as brusing easily and the bruises last for what seems like forever. I specifically mentioned Anna Maria Island Florida as there are so many kinds of rays. The ray that stung her was small. Maybe 12" across. Does anyone do any research on long term effects of sting ray venom? I recently found another post on another site where a man said his wife was stung about 6 months ago and now was undergoing tests for MS. I am starting to find a pattern here with women being stung and then later having to be tested for MS. Could be a specific species of ray? Or the size?
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1253197 tn?1331212710
I have nothing to add except that this had led to the most fascinating thread and once again Quix has added some very insightful comments. Thanks for sharing, follow up that MRI scan and I wish your wife well.,

Sarah
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572651 tn?1333939396
Hi I-freddy and welcome.  I'm sorry your wife is being checked for MS.

If you reread this thread carefully, you will see that we believe the stingray sting itself is NOT the cause of MS.  MS doesn't work that way.

However, being struck by the barb could be enough to set off the inflammatory/infection in the body that could provoke the MS out of being silent into an active phase.  I hope this makes sense.

good luck in finding answers,
Lulu
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I was stung by a sting ray in the side of the foot on June 19th.  It turned into and infection about a week later. After taking antibiotics for a week, I broke out into hives.  The doctor thought that I am allergic to antibiotics, which is a first for me.

After a week of steroids, the hives have come back strong again and are not responding to benedrill or zyrtec.  Is it possible they are related?  It seems such a long time since I was stung by the sting ray though
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147426 tn?1317269232
Hi, you've posted onto a thread in the MS Forum.  You may well be having a "serum sickness" reaction to the venom instead of an allergic reaction to the antibiotics.  If you are also having any joint pain and/or fever, then it is VERY likely serum sickness.  

This is treated with a course of steroids.  You might ask to see an Allergist/Immunologist, but generally a good GP can deal with this.

Quix
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My Dad was stung by a stingray three months ago and is having numbness and pain through out his body.  They now want to do a MRI.  The doctors told his there is no way the sting from a singray would be cause these problems.  After reading this post I am forwarding this to him to check on MS.
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1386048 tn?1281015933
oh wow.  i am thoroughly impressed and intrigued by all of this.  

is there no end to the talent and knowledge of this forum???

yes, discovery channel can be skipped tonight, a good dose of it exists here!!!!

michelle
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My husband was stung in the leg by a stingray which later became infected. Four months later he found out he had nephrotic syndrome. Could there be a connection?
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Has any one heard of epilepsy developing after having been stung by a sting ray. My boyfriend developed epilepsy a few months after being stung in 2007. He has has numerous tests over the last few years by neurologists and cardiologists which have all been inconclusive. He has had 18 seizures, 17 of which have been when he is eating and 1 during the night. Seeing this forum had lead us to wonder if there is any possibility being stung by the stingray could have caused these long term neurological symptoms....please help if you have heard of these type of case before. Thanks
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My foot had a classic ray wound from an unsighted critter on 06JUL12. The injury impacted me in a profound manner. My injured foot continues to swell up to no discernible rhythm and the ankle remains weak-like it's sprained. It's never returned to it's original form ( looks a bit like root ginger) and my skin on that foot has a darker hue to it.  The venom caused a Grade 111 ulcer, which carried a fungus called Lasiodiphlodia theobromae. I have deep tiredness on some days. I felt as if I was on the verge of death with the anti-fungal medication, so I gave up on it due to its toxicity. I believe I may still carry the fungus, which has an ultra slow growth rate. Something must be triggering the foot to swell out and for it to remain discoloured. I will follow up on my next consultation with the Infectious Diseases unit that is handling this case with an enquiry on MS. Lots of unknowns involved. Thank you.
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anybody know about scorpion bites/stings, got bite in Nicaragua on left side of heel, numbness tingling up to below knee, heart racing dizzy, increased blood pressure all that lasted for hours then developed blister that sealed over and took 2 months to absorb into my skin and slough off. Now I am still having symptoms of burning, feels like foot on fire still at times an achy pain at site like i maybe getting stung again and pain in my foot and ankle, an now my whole right leg somtimes hurts up to my hip ! any ideas on what going on. Also still having these all over muscle twitches seen neurlogist he says from toxin and not sure how long muscle twitches will last, also having fevers and now trying to see Infectious disease, been tired fevers, muscle aches,
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5112396 tn?1378021583
Hi there. You're on a rather old thread on a Multiple Sclerosis forum. A lot of the main answer-ers of the original question are no longer active here and were responding to something outside of the usual scope of what's mentioned here (though it's a fascinating read!).

From my non-professsional perspective, you're doing the right thing by seeing a neurologist and pursuing an infectious disease specialist. This is what I would have suggested. The medical run-around is never any fun, and I would understand how 'wait and see' would not be very satisfactory medical advice from your neuro. I feel very enlightened as to the far longer term (than I ever imagined) effects of envenomation!

But again, I'd go to a specialist. I'd want to try and confirm it's from the sting alone and that you're not also dealing with any co-creepies. Also, it may be possible to be treated symptomatically while you wait for things to run its course. The symptoms you describe sound like a terrible hit to your quality of life and your doctors should be working with you to make you more comfortable if possible.

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My sister was hit by a stingray in Tampa Florida in 2002 she was cut across 3 of her toes the big toe getting the worst damage. the ER submerged her foot in hot water which seem to help with the pain as long as her foot was submerged the pain medicine she was given did not help at all. We came back to tn. 2 days later and 2 weeks after the incident her scar oozed a clear liquid from her big toe and the doctors here in Tn didn't know how to treat it and again gave her pain meds. She now has an unknown auto immune disease that is breaking down her soft tissue and those symptoms started about 1 yr after her stingray incident. I am wondering if the toxin from the stingray may have something to do with her situation. her wounds were never lanced or cleaned by the ER Dr. I wonder if her body could have had a reaction to the venom causing her to develop the unknown auto immune disease that is causing her to have severe pain,loss of circulation in her extremities like feet and now hands and it has also attacked her gallbladder to which she had to have it removed.I guess I am wondering if it is possible to a person to have a severe reaction to the stingray toxin that is irreversible?
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I was recently wounded by a sting ray I unknowingly stepped on.
I do have systemic lupus & taking medication for seizure activity
some years ago. I have read that sting ray Neuro Toxins can induce
seizure activity in some people. LOOK up Stanford University Medical
Hospital. They had a symposium on sting ray Envenomation.They are in Palo Alto Ca. An urgent care doctor gave me the article ( which I am trying to
find ).  I am now experiencing extreme fatigue. My foot & leg are numb.
the infection seems to have abated but not the pain & strange symptoms.
Research the venom & enzymes of this marine creature. It is intense.
Call Stanford Medical & have a conversation with someone who is qualified.
Will post information as I go though this myself. Good luck. Chuniyo
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I was recently wounded by a sting ray I unknowingly stepped on.
I do have systemic lupus & taking medication for seizure activity
some years ago. I have read that sting ray Neuro Toxins can induce
seizure activity in some people. LOOK up Stanford University Medical
Hospital. They had a symposium on sting ray Envenomation.They are in Palo Alto Ca. An urgent care doctor gave me the article ( which I am trying to
find ).  I am now experiencing extreme fatigue. My foot & leg are numb.
the infection seems to have abated but not the pain & strange symptoms.
Research the venom & enzymes of this marine creature. It is intense.
Call Stanford Medical & have a conversation with someone who is qualified.
Will post information as I go though this myself. Good luck. Chuniyo
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I was tagged by a stingray about a week ago. I didn't put it in hot water for about 2 hours. The pain was un-real. Now, the reason I'm reading your post is because I have been extremely, extremely exhausted the last 3 days. And I am a super energetic person. I usually sleep 5 to 7 hours. I have been sleeping every single chance I can get these last few days. My face was also swollen this morning and my heart is pounding. I am really starting to think that stingray has done more to me than normal.
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987762 tn?1331031553
Hi there,

This thread is very old (2007) and was related to 'stingray's and MS', so you've landed in the MS community.......i would suggest you see your doctor, as it's very possible your immune system is fighting an infection from the sting and you need antibiotics or ? to get back to your normal.

Hope that helps............JJ
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