ABSTRACT Venomous fish are commonly found in Brazilian waters. The most important marine venomous fish species are stingrays (Dasyatidae, Gimnuridae, Myliobatidae, and Rhinopteridae families), catfish (Ariidae family), scorpionfish and lionfish (both Scorpaenidae family), and toadfish (Batrachoididae family). Meanwhile, Potamotrygonidae stingrays and Pimelodidae catfish are the most important venomous freshwater fish. The mechanisms of envenomation vary and involve various venomous apparatuses and glands. Despite not being highly developed, these venomous apparatuses in fish appear rudimentary, using structures such as fins and rays to inoculate toxins and rarely presenting with specialized structures. Toxins are produced by glandular tissue made up of proteinaceous cells, lacking true glands, and are positioned along the inoculation structures. However, systemic manifestations are rare. No antivenom serum has been developed for any species of American venomous fish. Brazilian venomous fish and their venoms have only recently attracted attention, leading to new studies not only addressing clinical issues in humans, but also exploring the discovery of new active substances with immense pharmacological potential.

Resumo O tamanduá-bandeira é um mamífero encontrado na América Central e na América do Sul. Esse animal possui garras que podem chegar a 6,5 cm de comprimento, utilizadas para escavar formigueiros e obter alimento, além de servir para sua defesa. Relatamos o caso de paciente masculino de 52 anos, com histórico de epilepsia, que foi levado desacordado ao pronto-socorro, devido a lesões no seu braço direito causadas por um tamanduá. Frente à suspeita de trauma vascular, o paciente foi submetido a exploração cirúrgica, que evidenciou uma lesão combinada de vasos braquiais, submetida a reparo. Apresentou boa evolução do quadro, recebendo alta hospitalar no segundo dia de pós-operatório e, no seguimento ambulatorial, evoluiu sem sequelas neurológicas ou vasculares.

Abstract The giant anteater is a mammal found in Central and South America. These animals have claws that can reach 6.5 centimeters in length, which they use to dig anthills to obtain food and for defense. We report the case of a 52-year-old male patient with a history of epilepsy who was taken unconscious to the emergency room due to injuries to his right arm caused by an anteater. He underwent surgical exploration to investigate suspected vascular trauma, revealing a combined (arterial and venous) injury of the brachial vessels, which were repaired. He recovered well and was discharged on the second postoperative day. During outpatient follow-up he continued to improve, with no neurological or vascular sequelae.

ABSTRACT Centipedes are venomous arthropods that have an elongated body, divided into many segments, presenting a pair of legs in each segment, adapted pairs of paws that simulate fangs and inject venom causing intense pain, with local erythema and edema, and rarely, blisters and skin necrosis. We present the case of a young woman pricked on her upper lip with intense swelling and local pain and discuss the real danger of envenomation and the therapeutic measures that should be taken.

ABSTRACT Background: Freshwater stingrays are fish that have adapted to the rivers and lakes in South America. The expansion of the Potamotrygonidae family in the Paraná River began after the damming of the Sete Quedas Falls, reaching the mouth of the Paranapanema and Tietê rivers approximately 20 years ago via the locks of the hydroelectric power plants. They are not aggressive animals; however, they have one to four stingers on their tails covered by a venom-producing epithelium and can cause severe envenomation in fishermen and bathers if stepped on or manipulated. Methods: We conducted a descriptive, retrospective, and prospective study by monitoring the fishing of the Potamotrygon genus in the lower Tietê River, mapping the location of the rays as a fishery product of professional fishermen and/or recording images of the fish caught. Results: Sixteen stingrays of the Potamotrygon genus were mapped by monitoring fishermen's fish products in the extensive area between the municipalities of Pereira Barreto and Buritama, São Paulo state. Conclusions: The lower Tietê River is fully colonized by freshwater stingrays and this expansion likely continues upstream, reaching various sub-basins of the river. The advancement of these venomous fish in areas where they did not exist previously requires education programs and interaction with the community to avoid serious injuries in bathers and fishermen and the unreasonable extermination of the animals.

ABSTRACT Animal bites are a common problem in the emergency room. There are many reports of isolated cases (mainly of domestic mammals); however, texts with more comprehensive and general guidance on these kinds of bite injuries are necessary, including those caused by wild mammals, reptiles, and even fish. This review aims to update knowledge on this problem, which includes human and domestic and wild animal bites. Health teams in emergency care centers should be aware of the initial and late measures required to control this problem.

Abstract Urbanization, pollution and the modification of natural landscapes are characteristics of modern society, where the change in human relations with the environment and the impact on biodiversity are environmental determinants that affect the health-disease relationship. The skin is an organ that has a strong interface with the environment and, therefore, the prevalence patterns of dermatoses may reflect these environmental changes. In this article, aspects related to deforestation, fires, urbanization, large-scale agriculture, extensive livestock farming, pollution and climatic changes are discussed regarding their influence on the epidemiology of skin diseases. It is important that dermatologists be aware of their social responsibility in order to promote sustainable practices in their community, in addition to identifying the impacts of environmental imbalances on different dermatoses, which is essential for the prevention and treatment of these diseases.

Abstract Gnathostomiasis is a parasitic zoonosis caused by the helminth Gnathostoma spp., acquired through the consumption of raw or undercooked contaminated aquatic animals.The disease is endemic in Southeast Asia and Central America. Two male patients, both middle-aged, presented with single itchy erythemato-edematous plaques on the anterior thorax and left flank. Both had consumed raw fish in the Amazon region. The clinical and epidemiological examinations suggested gnathostomiasis, and treatment with albendazole caused total regression of the lesions. Health teams should be familiar with the disease to provide correct diagnosis. The control strategy should be based on health education for the population.

Abstract INTRODUCTION: Mantis shrimps or siriboias are crustaceans belonging to the order Stomatopoda. They are known for their strong claws, which they use for defense and capturing their prey. They are classified into two groups: the spearers, which pierce the prey with sharp projections, and the smashers, which strike their prey with high-powered punches. These animals are highly feared by fishermen, and there are frequent anecdotal reports of human injuries caused by these crustaceans. METHODS: A questionnaire about injuries in humans caused by these stomatopods was administered to 23 fishermen of Colony Z10 in Ubatuba, São Paulo state, Brazil, and a survey of the literature on injuries in humans caused by these animals was carried out. RESULTS: The fishermen consider the mantis shrimp dangerous and avoid direct contact with them on account of the associated risk. We describe five reports of human injuries caused by these animals: four by the claws and one by the tail spikes. CONCLUSIONS: We describe the first aid treatment, prevention, and recommendations for such cases and propose the distribution of educational leaflets among the fishermen colonies.

Resumo Introdução: ferimentos causados por peixes são comuns entre pescadores e, se não forem adequadamente assistidos, podem levar a complicações significativas. Objetivo: reportar o caso de um pescador que se acidentou com um camurim/robalo (Centropomus spp.) e apresentou infecção secundária com sequelas graves. Métodos: as informações foram obtidas por meio de revisão de prontuários, entrevista com o paciente e registro fotográfico. Resultados: um pescador de 48 anos se acidentou, com a espícula da base da nadadeira do peixe, na falange do quinto quirodáctilo da mão esquerda, apresentando sinais flogísticos em todo o membro. O serviço de saúde não dispunha de condições para identificar o agente da infecção e diferentes antibióticos foram administrados. Sem resultados expressivos, a terapia antibiótica foi suspensa e foi adotado tratamento sintomático. Após 32 dias de hospitalização, o paciente teve alta. No entanto, dois meses após o acidente, a vítima desenvolveu abscesso do membro com limitação de movimentos dos quirodáctilos, necessitando de procedimento cirúrgico. Após o controle da infecção, apresentou sequelas como atrofia muscular, perda parcial de movimento, redução da capacidade motora, sensibilidade local e aparência da mão em garra. Conclusão: lesões causadas por peixes em pescadores podem resultar em consequências graves e irreversíveis e mais atenção deve ser dada ao tema.

Abstract Introduction: fish injuries are common among fishers and, if not properly assisted, can lead to major complications. Objective: to report the case of a fisherman who had an accident with a snook fish (Centropomus spp.) and presented secondary infection with severe sequelae. Methods: the information was obtained by reviewing medical records, interviewing the patient, and photographic record. Results: a 48-year-old fisherman was injured by the spike on the base of the fish fin. It affected the phalanx of his left hand fifth finger, showing signs of inflammation throughout the limb. The health service was unable to identify the infectious agent and prescribed several antibiotics. Without substancial results, the doctors discontinued the antibiotic therapy and adopted a symptomatic treatment. After 32 days in hospital, the patient was discharged. However, two months after the accident, he presented an abscess in the limb, which limited the fingers movement and required a surgical procedure. After the infection was controlled, he presented some sequelae such as muscle atrophy, partial loss of movement, reduced motor capacity, local sensitivity, and clawed-shaped hand. Conclusion: injuries caused by fish can result in serious and irreversible consequences, and more attention should be paid to the subject-matter.