gms | German Medical Science

While bathing off a Seychelle shore at night, a 45 year old female was injured at the medial lid angle of her left eye by the beak of a jumping needlefish. A local physician extracted an organic foreign body and ordered antibiotics.

The patient returned to Germany two days later and presented with mild orbital inflammation, reduced motility and intermittend diplopia. A CT scan revealed a foreign body of bone density in the nasal orbit and a 40x5mm fragment of a fish beak was extracted under general anesthesia without complications. Subsequently, the inflammation subsided under antibiotic therapy. A follow-up CT scan 4 weeks postoperatively showed a retained fragment of 1x1mm which was left in place. Local and systemic antibiotic treatment was continued and at two months, a slight upper lid edema and minimal upgaze impairment were the only findings. At this point, medication was discontinued. Six months after the incident, the patient had fully recovered.

Injuries by "jumping fishes" in needlefish habitat regions can lead to severe complications. Cases of deadly head- and brain injuries in children have been reported. Therefore, tourists traveling to high risk areas should be informed and cautioned not to swim at night. In case of an injury, imaging studies are mandatory to rule out cranial penetrations and retained foreign bodies.