Paralytic shellfish poisoning
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Background
- Associated with red tides, but can occur independently
- Caused by ingestion of contaminated shellfish which harbor toxin (heat stabile) producing algae
- Shellfish typically from colder waters (New England, Pacific NW, Alaska)[1]
Clinical Features
- Symptoms develop within minutes to hours of ingestion
- Typically neurologic symptoms only: Paresthesias, dizziness, ataxia. May progress to dysphagia and/or respiratory failure. [2]
- Report any suspect cases to local department of health
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
- Based on symptoms plus history of shellfish ingestion
Management
- Supportive. Some cases may require intubation / mechanical ventilation
Prognosis
- Mortality up to 12% if untreated [3]
- Symptoms usually self resolved within hours to days
See Also
References
- ↑ Centers for Disease Control and Prevention (CDC). Paralytic shellfish poisoning --- southeast Alaska, May-June 2011. MMWR Morb Mortal Wkly Rep 2011; 60:1554.
- ↑ Etheridge SM. Paralytic shellfish poisoning: seafood safety and human health perspectives. Toxicon 2010;56:108
- ↑ Mines D et al. Poisonings: food, fish, shellfish. Emerg Med Clin North Am 1997;15:157.