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Paralytic shellfish poisoning
From WikEM
Contents
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 and envenomations
- Toxins
- Scombroid
- Ciguatera
- Neurotoxic shellfish poisoning
- Paralytic shellfish poisoning
- Tetrodotoxin (e.g. pufferfish)
- Stingers
- Venomous fish (catfish, zebrafish, scorpion fish, stonefish)
- Lionfish
- Sea urchins
- Cone shells
- Nematocysts
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Coral reef
- Fire Corals
- Sea anemones
- Sea wasps
- Bites
Evaluation
- Based on symptoms plus history of shellfish ingestion
Management
- Supportive. Some cases may require intubation / mechanical ventilation
Prognosis
- Mortality up to 12 percent 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.
Authors
Joe Carpenter, Ross Donaldson, Neil Young, Daniel Ostermayer
