Tetrodotoxin: Difference between revisions
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==Background== | ==Background== | ||
*Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus) | *Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus) | ||
**Heat-stable toxin not destroyed by washing, freezing or cooking | |||
*Blocks neuronal action potential by blocking voltage-gated sodium channels | *Blocks neuronal action potential by blocking voltage-gated sodium channels | ||
*Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity | *Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity | ||
Revision as of 16:56, 11 September 2017
Background
- Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
- Heat-stable toxin not destroyed by washing, freezing or cooking
- Blocks neuronal action potential by blocking voltage-gated sodium channels
- Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity
Clinical Features
Onset of symptoms usually within 30 min to 4 hours after eating pufferfish
- Paresthesias
- Headache
- Vomiting, diarrhea, abdominal pain
- Ascending paralysis
- Respiratory failure
- Death
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
Evaluation
- Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
- Evaluate for other treatable causes of symptoms
Management
- Supportive care, intubate if concern for progressive paralysis
- Acetylcholinesterase inhibitors (e.g. neostigmine)[1]
Disposition
- Admit, may need ICU
See Also
External Links
References
- ↑ Tintanelli's