Portuguese Man-o'-war ( Physalia physalis ) Envenomation in a Child: First Confirmed Case in Malaysia.
Jubaida Paraja, Khairun Nisa Sulaiman, Mohamad Hamim Mohamad Hanifah
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Case in brief
A 9-year-old boy developed sudden, intense burning pain in his right forearm after being stung while swimming off Labuan Island. Examination showed a linear erythematous papular rash; he was distressed, with transiently elevated blood pressure and heart rate, but remained hemodynamically stable. A photograph of the organism showed features characteristic of Physalia physalis, and nematocysts were identified in a skin sample by cellophane tape and light microscopy. Intravenous morphine provided effective analgesia, and he was admitted for observation.
What made this case unusual
The report documents a confirmed P. physalis envenomation in Malaysia, with identification supported both by the organism’s photograph and nematocysts recovered from the skin.
Diagnostic / clinical pearl
When the organism is not available for direct identification, nematocysts recovered from a skin sample using the cellophane tape method and light microscopy can support diagnosis.
Why it matters
The authors note gaps in region-specific guidance and emphasize public education about marine envenomation in tropical settings.