DAN Medical Frequently Asked Questions

Will Sponges ever Hurt Me

On a recent dive trip I was not wearing gloves and I touched a vase sponge. The next moring I woke up with my hand swollen and itching. I wasn't sure what happened. Everyone I asked had a different theory. One person suggested it was from the sponge. I didn't think sponges were harmful. Can sponges really cause a rash?

Most sponges are harmless and not associated with human illness. However, unprotected contact may result in an itchy rash which can develop within as little as 10 to 20 minutes or after a few hours following contact and may take several weeks to resolve¹. Symptoms can include itching, burning, localized swelling, blister formation, desquamation (shedding of outer skin layers) and rarely systemic manifestations to include fever, chills, malaise, nausea, vomiting and dizziness^1,10. Fortunately most skin symptoms are relatively mild and are similar to dermatitis following contact with other mildly toxic marine animals.

Skin symptoms may result from allergic, sting or spicule-induced reactions and differentiating between these potential sources is often difficult¹.

Skin reactions can result from contact with organisms that colonize the sponge (sponge diver’s disease) – the principal culprits being Cnidarians (polyps), bristle worms and other Echinoderms⁷. There are a few species linked to severe reactions and include the Hawaiian or West Indian Fire Sponge, Tedania ignis; and the poison Bun Sponge, Fibula (or Neofibularia) nolitangere^2,5,6. Symptoms and signs of contact are more likely when the area affected has pre-existing skin lesions, open wounds and when contact is made with the silica or calcium carbonate spicules embedded within the sponge’s structural tissue^4,5,6.

First aid

Gently dry the affected area and remove any foreign material. Spicules should be removed, if possible, with adhesive tape, thin layer of rubber cement or products used for facial peels^6,8,9.

Soak the affected area with 5% acetic acid solution (vinegar) for 10 to 30 minutes 3 to 4 times a day^6,8,9.

Clean the affected area with soap and water and keep the area clean, dry and well-aerated.

Leave blisters intact and allow them to dry out naturally.

Monitor for signs of infection.

Steroid ointments may prove useful in reducing skin irritation.

Tetanus vaccination/booster is often recommended³.

Other medical management may include corticosteroids, antihistamines and other medications used for severe reactions.

Prevention:

Avoid direct contact with sponges. Sponges should not be handled with bare hands. Dry sponges may still remain toxic or regain toxicity upon rehydration¹.

Those providing 1st aid, should wear protective gloves to minimize the risk of skin irritation from stings or spicule contact¹.

Authors: Nicholas Bird MD, MMM

Matias Nochetto, MD

References:

1. Auerbach, Paul. Envenomation by Aquatic Invertebrates (Ch 80). Wilderness Medicine, 6th Ed. 2012. PP 1596-1599.

2. Kizer KW: Marine envenomations. J Toxicol Clin Toxicol 1984; 21:527.

3. Kizer KW, Auerbach PS: Marine envenomations: Not just a problem of the tropics. Emerg Med Rep 1985; 6:129.

4. Russell FE, Nagabhushanam R: The venomous and poisonous marine invertebrates of the Indian Ocean. New Delhi, Oxford and IBH, 1996.

5. Schwartz S, Meinking T: Venomous marine animals of Florida: morphology, behavior, health hazards. J Fla Med Assoc 1997; 84:433.

6. Sims JK, Irei MY: Human Hawaiian marine sponge poisoning. Hawaii Med J 1979; 9:263.

7. Southcott RV: Human injuries from invertebrate animals in the Australian seas. Clin Toxicol 1970; 3:617.

8. Southcott RV, Coulter JR: The effects of the southern Australian marine stinging sponges, Neofibularia mordens and Lissodendoryx sp. Med J Aust 1971; 2:895.

9. Yaffee HS: Irritation from red sponge. N Engl J Med 1970; 282:51.

10. Yaffee HS, Stargardtner F: Erythema multiforme from Tedania ignis. Arch Dermatol 1963; 87:601.