Ciguatera
Background
- Most cases tropics and subtropics, between 35 degrees north and south latitudes
- Most common fish are barracuda, moray eel, amberjack, and certain types of grouper, mackerel, parrotfish, and red snapper
- Caused by fish eating dinoflagellates that grow on and around coral reefs and contain a heat-stable toxin
Diagnosis
- GI symptoms
- vomiting, diarrhea, and abdominal cramping
- 3-30hrs after eating contaminated fish
- Neurologic symptoms
- Paresthesias, painful teeth, painful urination, blurred vision, nerve palsies, and hot/cold temperature reversal
- Cardiovascular symptoms
- Bradycardia, heart block, and hypotension.
^Diagnosis based on history and physical only
Treatment
- Symptomatic
- Prevent recurrances
- Do not injest alcohol, caffeine, nuts or fish for 6 months
Prognosis
- Neurologic symptoms typically persist from a few days to several weeks
- ~20% of patients have symptoms that persist for months
- <2% have symptoms that last for years
See Also
Source
UpToDate