Paralytic shellfish poisoning

Background

• Associated with red tides, but can occur independently
• Caused by ingestion of contaminated shellfish which harbor toxin producing algae
• Shellfish typically from colder waters (New England, Pacific NW, Alaska)

Diagnosis

• Based on symptoms plus history of shellfish ingestion
• Symptoms develop within minutes to hours of ingestion

Differential Diagnosis

Marine toxins, envenomations, and bites

• Toxins
  • Ciguatera
  • Neurotoxic shellfish poisoning
  • Paralytic shellfish poisoning
  • Scombroid
  • Tetrodotoxin (e.g. pufferfish)
• Stingers
  • Stingray injury
• Venomous fish (catfish, zebrafish, scorpion fish, stonefish)
  • Cone shells
  • Lionfish
  • Sea urchins
• Nematocysts
  • Coral reef
  • Fire coral
  • Jellyfish (Cnidaria)
    • Box jellyfish
    • Sea wasp
  • Portuguese man-of-war
  • Sea anemones
  • Seabather's eruption
• Phylum porifera (sponges)
• Bites
  • Alligator and crocodile attacks
  • Octopus bite
  • Shark bite
• Infections
  • Vibrio species in saltwater
  • Aeromonas species in freshwater

Treatment

• Symptomatic

Prognosis

• Mortality up to 12 percent if untreated

See Also

• Marine toxins and envenomations