Neurotoxic shellfish poisoning: Difference between revisions
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*Associated with red tide | *Associated with red tide | ||
*Seen in Southeast US, Gulf of Mexico, Caribbean, New Zealand | *Seen in Southeast US, Gulf of Mexico, Caribbean, New Zealand | ||
*Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized<ref name= | *Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized<ref name=James> James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40. </ref> | ||
==Diagnosis== | ==Diagnosis== | ||
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**Similar to [[ciguatera]] | **Similar to [[ciguatera]] | ||
**GI symptoms - vomiting, diarrhea, abdominal cramping; usually within 30 minutes to 3 hours of ingestion | **GI symptoms - vomiting, diarrhea, abdominal cramping; usually within 30 minutes to 3 hours of ingestion | ||
**Neurologic symptoms - parethesias, dizziness, ataxia. Can also see hot/cold temperature sensation reversal | **Neurologic symptoms - parethesias, dizziness, ataxia. Can also see hot/cold temperature sensation reversal <ref name=Morris>Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4. | ||
*If Inhaled | *If Inhaled | ||
**Upper respiratory tract irritation, rhinorrhea, bronchoconstriction | **Upper respiratory tract irritation, rhinorrhea, bronchoconstriction | ||
**Generally affects patients with chronic respiratory disease (ie asthma/COPD) <ref> Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187. </ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Prognosis== | ==Prognosis== | ||
*Most patients fully recover within 72 hours | |||
==See Also== | ==See Also== | ||
*[[Marine toxins and envenomations]] | *[[Marine toxins and envenomations]] | ||
Revision as of 23:00, 6 January 2016
Background
- Associated with red tide
- Seen in Southeast US, Gulf of Mexico, Caribbean, New Zealand
- Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized[1]
Diagnosis
- Based on symptoms and history of ingesting shellfish or proximity to red tide
- If Ingested
- Similar to ciguatera
- GI symptoms - vomiting, diarrhea, abdominal cramping; usually within 30 minutes to 3 hours of ingestion
- Neurologic symptoms - parethesias, dizziness, ataxia. Can also see hot/cold temperature sensation reversal Cite error: Closing
</ref>missing for<ref>tag
Differential Diagnosis
Marine toxins, envenomations, and bites
- Toxins
- Ciguatera
- Scombroid
- Tetrodotoxin (e.g. pufferfish)
- Shellfish poisoning
- Amnesic shellfish poisoning
- Diarrheal shellfish poisoning
- Neurotoxic shellfish poisoning
- Paralytic shellfish poisoning
- Stingers
- Venomous fish
- Cone shell
- Lionfish
- Sea urchins
- Crown-of-Thorns Starfish
- Stonefish
- Other: Catfish, zebrafish, scorpion fish
- Nematocysts
- Coral reef
- Fire coral
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Sea anemones
- Seabather's eruption
- Phylum porifera (sponges)
- Bites
- Infections
Treatment
- Symptomatic
Prognosis
- Most patients fully recover within 72 hours
See Also
Source
- ↑ James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.