Fire coral envenomation has been considered in the past to produce mild localized symptoms of skin irritation, burning, or stinging pain followed by linear erythema, urticaria and pruritus with regression over a 1–2 week period. A case is presented strongly suggesting that a direct relationship exists between such a sting and subsequent long thoracic neuropathy with serratus anterior muscle paralysis. Systemic symptoms of generalized malaise, fever, and significant burning pain around the shoulders following envenomation, along with positive serological testing for Millepora immune specific IgG indicating an immune response to the venom, lends credence to these assumptions.
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