Oral inflammatory response to a sting from a Portuguese man-of-war.

A careful history was taken in an attempt to document an unusual delayed inflammatory reaction involving the ears and oral cavity. Severe oral and auricular inflammations have been described as apparent reactions to stings on the patient's foot by a Portuguese man-of-war (P physalia). Toxin was injected into the right foot and resulted in a delayed type of severe swellings and inflammation. The soft palate, cheek, periodontal tissues, and lower lip were primarily involved. Oral inflammations coincided with massive, acute, inflammatory lesions behind the ears. Delayed oral and ear inflammations suggest an unusual reaction to the toxin of the sting of P physalia; it was possibly hypersensitive in nature. The described pathology seems unique to medical reports concerning the Portuguese man-of-war. The foot responded rapidly to topical application of ammonia solution. Antibiotic therapy taken orally apparently helped resolve the oral and ear lesions in approximately 11 days.