GC: n

S: NCBI – https://www.ncbi.nlm.nih.gov/pubmed/10615756 (last access: 3 July 2019); RESG – https://www.researchgate.net/publication/221857744_Australian_Carybdeid_jellyfish_causing_Irukandji_syndrome (last access: 3 July 2019).

N: 1. The syndrome was given its name in 1952 by Hugo Flecker, after the Aboriginal Irukandji people who live in Palm Cove, north of Cairns, Queensland, Australia, where stings are common.

• Irukandji Jellyfish Story. The painting depicts the story of the Irukandji jellyfish, which was named after the Yirrganydji (Irukandji) tribe in the 1950s by Dr. Hugo Flecker and his team of scientists. The kapa (white clay) and pukan (black charcoal) represents the jellyfish while the wupa (red ochre) lines symbolises the kalpal (blood) of the Yirrganydji People.

2. Irukandji syndrome is a distressing envenoming secondary to the sting of Carukia barnesi and other, as yet unidentified, jellyfish found in coastal waters of tropical Australia. It has also been reported in Hawaii, the Caribbean, Asia and Papua New Guinea. In a small number of cases, life‑threatening hypertension and pulmonary oedema may develop. Two fatalities have been attributed to this condition in Australia. Management is symptomatic and supportive. Antivenom has not yet been developed.
3. Venom composition and actions have not been fully characterised. It is thought to induce massive catecholamine release.
4. Clinical presentation and course:

• The initial sting is usually not felt and there is a short delay to the onset of systemic symptoms. Local signs, such as welts or dermal markings, are minimal or absent
• Multiple systemic symptoms develop from 30–120 minutes after contact with the jellyfish. These include a sense of impending doom, agitation, dysphoria, vomiting, generalised sweating and severe pain in the back, limbs or abdomen. Hypertension and tachycardia are common.
• Symptoms usually settle within 12 hours
• Severe envenoming manifests within 4 hours with on‑going significant opioid requirements. These patients are at risk of toxic cardiomyopathy, cardiogenic shock and pulmonary oedema and may require intubation and mechanical ventilation
• Intracerebral haemorrhage occurred in two patients within 3–4hours of the sting, presumably due to uncontrolled hypertension.

S: 1. Wikipedia – https://en.wikipedia.org/wiki/Irukandji_syndrome (last access: 3 July 2019); Dawul – http://dawulwuru.com.au/files/4314/0360/2666/Yirrganydji_Plan_Online.pdf (last access: 3 July 2019). 2 to 4. LITFL – https://litfl.com/irukandji-syndrome/ (last access: 3 July 2019).

SYN:
S:

CR: jellyfish