In reply: While overcoagulation causing intracerebral haemorrhage could have caused the death of the patient we described,1 he was normotensive until developing signs and symptoms of Irukandji syndrome some 20 minutes after being stung. The Irukandji syndrome is, and always has been, a clinical diagnosis only. Biochemical and pathological test results become abnormal later, but are not diagnostic — actual cause and effect have been described only once, with the experiment unlikely to be repeated!2
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