History
Any octopus can bite with its parrot-like chitinous beak.
The bite of the blue-ringed octopus is usually painless; however, the individual may experience a reaction similar to a bee sting.
If envenomation has occurred, symptoms are likely to start within 10 minutes of being bitten.
If a significant envenomation has occurred, the individual will rapidly progress from perioral and peripheral paresthesias through the following signs and symptoms.
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Nausea and vomiting
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Blurred vision
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Ataxia
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Muscle paralysis
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Respiratory failure, which may lead to cardiac arrest and death
Anaphylactoid or anaphylactic reactions have not been reported.
Physical Examination
The individual is usually bitten on an extremity and sustains 1-2 small puncture wounds.
Local reaction may be minimal, but it can progress to include pain, edema, and erythema of the entire extremity.
The patient becomes flaccid once paralyzed.
Complications
If acute paralysis and respiratory arrest is not immediately recognized and appropriately treated, anoxic brain injury or death will result.
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Blue-ringed octopus. Image courtesy of Simon Dubbin.