Although blue-ringed octopus bites are known for being potentially deadly, bites by most octopus species are generally not problematic.
Recently, however, scientists have come to understand that all octopuses may be venomous to some degree. Medical literature indicates that bites by octopuses of the same class as the giant Pacific have resulted in ulceration.
Now this one is a giant Pacific octopus – best not to touch that either.
The small puncture wound developed into what appeared to be an ulcerous lesion, similar to one that developed following a common octopus bite documented in a 2011 case report.
The delay in proper wound care may have been a complicating factor. DAN recommends washing marine bites immediately with soap and clean water to minimise the risk of infection, which can impair healing and lead to significant tissue damage.
Divers should not dive with open wounds, because exposure to the aquatic environment can increase infection risk.
Monitoring the wound site is important, because signs of infection can appear from within hours to several weeks following an injury.
The immediate swelling the diver experienced may have been a consequence of the initial trauma, the exposure to myriad antigens that followed and/or toxins. The prolonged symptoms were most likely a result of infection.
The drysuit wrist-seals may have been a secondary complicating factor. The swelling was probably the result of an acute inflammatory reaction, but the tight-fitting seals may have compromised distal perfusion or blood flow, further exacerbating symptoms.
In addition to inflammation of the affected area, other symptoms of infection include pain, redness and immobilisation. These symptoms can be remembered using the acronym PRISH: pain, redness, immobilisation (impaired function), swelling and heat (elevated warmth of the infected area).
The cause of the diver’s nausea on completing the dive is unclear.
A third complicating factor in this case may have been the delay in medical care. DAN advises divers to treat wounds caused by marine life like any other animal bite, and seek prompt medical attention. In this case, the wound was evaluated 10 days after the incident, delaying treatment that might have limited progression of the symptoms.
Initially the doctor prescribed a 10-day course of the antibiotic levofloxacin, but evolving symptoms and progressing discoloration prompted the addition for 10 days of another antibiotic, amoxicillin and clavulanate, along with an antihistamine to manage the itching.
This incident underlines that timely treatment of wounds can reduce risk of serious infection. Whenever possible, divers should photograph wounds, because images can help medical staff provide more effective and efficient care.
Handling marine life may lead to injuries, and some of these can result in serious complications.