A 26-year-old backpacker is snorkelling off Port Douglas in far north Queensland in December when she feels a mild sting on her forearm, leaving only faint redness at the site. Thirty minutes later, on the beach, she develops severe cramping pain in her back, chest and abdomen, with vomiting, profuse sweating, restlessness and a feeling that something terrible is about to happen. Her blood pressure is 178/104 mmHg and heart rate is 122/min. Which one of the following is the most likely diagnosis?
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