Blue Bottle Sting

Bluebottles (Physalia spp.) are the most common cause of jellyfish stings worldwide and in Australia, generally found in NSW and Queensland waters. Most stings are mild, but severe stings can occasionally need hospital care.

Clinical features

• Immediate, intense local pain — typically resolves within 1–2 hours
• Linear erythematous/urticarial eruption along the tentacle contact line, lasting a day or more
• Systemic effects in ~2% of cases — nausea, vomiting, abdominal pain, myalgia; respiratory distress is rare

Treatment

• Wash the sting site with seawater and carefully remove tentacles.
• Hot water immersion (~45°C) for 20 minutes — supported by an RCT showing it’s more effective than ice packs for pain relief.
• Avoid vinegar for bluebottle stings — it does not help and may worsen pain (unlike box jellyfish, where vinegar is specifically indicated).
• Other minor jellyfish stings (Pelagia, Cyanea, Aurelia, some Carybdeidae) present and are managed the same way.

From Marine envenomations, Berling & Isbister, Australian Family Physician 44(1-2), 2015 (reprinted); citing Loten et al., Med J Aust 2006 (hot water vs ice pack RCT).