1/4. A brief case report and review of ciguatera poisoning.Although ciguatera fish poisoning is generally a mild, self-limited disease, both life-threatening acute reactions and troublesome chronic symptoms can occur. Because ciguatera has been largely confined to tropical locations, a relative lack of recognition exists among many US physicians. As access to tropical locations has increased, so has the distribution of ciguatera. Herein, we present a case report and review the current literature on ciguatera.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. ciguatera poisoning after ingestion of imported jellyfish: diagnostic application of serum immunoassay.Ciguatera fish poisoning is an important public health problem wherever humans consume tropical and subtropical fish. It accounts for over half of fish-related poisonings in the united states but is uncommonly diagnosed and underreported. Produced by dinoflagellates, ciguatoxin accumulates up the food chain in herbivorous and carnivorous fishes. cnidaria jellyfish and related invertebrates) have not previously been associated with direct ciguatera intoxication in humans. We report the first case of ciguatera fish poisoning associated with cnidarian ingestion. A 12-year-old Tongan female presented to our Emergency Department with mid-abdominal pain, nausea, change in mental status, and new-onset movement disorder after ingestion of jellyfish imported from american samoa. Clinical diagnosis was confirmed by strongly positive serum identification of ciguatoxin and related polyether toxins (including okadaic acid) with a rapid extraction method (REM) and highly reliable solid-phase immunobead assay (S-PIA) performed by the Food toxicology research Group, University of arizona. Ciguatera pathophysiology, clinical presentation, differential diagnosis (including consideration of palytoxin poisoning), and treatment are briefly reviewed. We emphasize the growing incidence of ciguatera fish poisoning outside "high-risk" areas. In regions with immigrant populations, privately imported exotic fish may be toxin vectors. Marine species other than carnivorous fish are now suspect in human ciguatera intoxication. Reliable tests can aid in premarket fish testing, diagnosis, and follow-up of ciguatera fish poisoning. The global prevalence of marine toxins demands fishermen, consumers, and physicians maintain a high index of suspicion for ciguatera fish poisoning.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Emergence of imported ciguatera in europe: report of 18 cases at the Poison Control Centre of Marseille.BACKGROUND: Ciguatera is a disease caused by the ingestion of fish containing the toxins of Gambierdiscus toxicus. This dinoflagellate is frequently found in damaged coral reef systems. Previously rare in europe, this disease entity is now seen in tourists returning from tropical countries. CASE SERIES: Eighteen patients were examined between 1997 and 2002. Nine poisonings occurred in atlantic ocean islands, eight in pacific ocean islands, and one in the Egyptian Red Sea coast. Gastrointestinal signs were always present in the Atlantic areas, but were less severe or absent in the Pacific areas. All patients had sensory disturbances, and two of them had motor disturbances affecting the respiratory muscles and leading to the death of a 73-year-old man in cuba. The 17 surviving patients returned to france and for 2 to 18 months suffered from arthralgias, myalgias, or pruritis. CONCLUSION: Ciguatera is a newly imported intoxication in europe. As the number of international tourists grows each year, this type of poisoning will be seen more frequently. Furthermore, as the condition of coral reefs declines around the world and the prevalence of G. toxicus increases, physicians in non-tropical countries should be prepared to manage such poisoned patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Ciguatera fish poisoning--texas, 1998, and south carolina, 2004.Ciguatera fish poisoning is characterized by gastrointestinal symptoms such as nausea, vomiting, and diarrhea and neurologic symptoms such as weakness, tingling, and pruritus (itching). The condition is caused by eating fish containing toxins produced by the dinoflagellate Gambierdiscus toxicus, a one-celled plantlike organism that grows on algae in tropical waters worldwide. Because these toxins are lipid soluble, they accumulate through the food chain as carnivorous fish consume contaminated herbivorous reef fish; toxin concentrations are highest in large, predatory fish such as barracuda, grouper, amberjack, snapper, and shark. Because fish caught in ciguatera-endemic areas are shipped nationwide, ciguatera fish poisoning can occur anywhere in the united states. This report describes ciguatera fish poisoning in four persons (two in 1998, two in 2004) who ate fish caught by recreational fishers in waters outside of ciguatera-endemic areas (e.g., the Caribbean Sea and the Atlantic and Gulf Coast waters off southern florida). These cases underscore the need for physicians, regardless of whether they are in a ciguatera-endemic area, to consider ciguatera in patients who have gastrointestinal or neurologic symptoms after eating large, predatory fish.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |