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Marine Biotoxins: Symptoms and Monitoring Programs
Published in Hafiz Ansar Rasul Suleria, Megh R. Goyal, Health Benefits of Secondary Phytocompounds from Plant and Marine Sources, 2021
Huma Bader Ul Ain, Farhan Saeed, Hafiza Sidra Yaseen, Tabussam Tufail, Hafiz Ansar Rasul Suleria
There is no neutralizing agent accessible for ciguatera poison. Regurgitating must be initiated if the patient is wake and has eaten ciguatera poison containing fish in the last 3 to 4 hours. Ipecac drug is used because regurgitating, but numerous specialists think ipecac may cause electrolyte imbalance in the body, so that IV liquids are must in worst sickness. Initially, the administration of activated charcoal within 3 to 4 hours after the ingestion of toxicant may adsorb the poison. Amitriptyline and gabapentin may diminish neural side effects. Intravenous Mannitol is the main CFP treatment assessed by randomized single-or double-blind studies to counteract the symptoms during the initial 2–3 days of poisoning [13, 43, 54]. Diphenhydramine, hydroxyzine, and NSAID’s may help to treat irritation and eliminate painful sensation. Stay away from liquor, fish, nuts, and nut oils are strongly recommended after the use of ciguatera poison to reduce the chances of symptoms reoccurrence.
Neurotoxicology
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Sean D. McCann, Trevonne M. Thompson
Ciguatera is a unique toxicologic syndrome caused by ingestion of ciguatoxin, a poison produced by microscopic marine organisms called dinoflagellates and bioaccumulated in large reef fish such as barracuda, amberjack, sturgeon, sea bass, or grouper. The neurologic toxicity of ciguatoxin ciguatera appears similar to peripheral neuropathies with painful paresthesia of the extremities, however, it is notable for the unique finding of a sensation of hot and cold reversal (patients report cold objects feel scalding hot and vice versa). Ciguatoxin's effects are mediated by its ability to maintain sodium channels in an open position leading to continuous cell depolarization rather than neurodegeneration as with most toxic neuropathies. GI symptoms are also prominent in most cases. Treatment is primarily supportive, and no effective antidote has been identified. Some early studies appeared to show improvement with mannitol administration, but a subsequent double-blind randomized controlled trial showed no benefit.
Ciguatera: A Treating Physician's Perspective on a Global Illness
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Ritchie C. Shoemaker, James C. Ryan
Potential confounders for acute, possibly milder cases of ciguatera include viral illness, food poisoning (it is!), stress, irritable bowel syndrome, dehydration, or hyperventilation. Diagnostic modalities of benefit rarely are requested, including deficits in visual contrast sensitivity; stress echocardiograms done to confirm acquired pulmonary hypertension; pulmonary function testing looking for restrictive lung disease; and commercially available laboratory tests showing multiple abnormalities as reported in 2010 (3). A careful clinician will more likely than not see most of these elements after the acute ciguatera illness is 30 days old and potential chronic illness parameters arise.
Ciguatera fish poisoning in France: experience of the French Poison Control Centre Network from 2012 to 2019
Published in Clinical Toxicology, 2021
Luc de Haro, Corinne Schmitt, Sandra Sinno-Tellier, Nathalie Paret, David Boels, Gaël Le Roux, Jérôme Langrand, Nicolas Delcourt, Magali Labadie, Nicolas Simon
Ciguatera fish poisoning (CFP) is frequent in the tropics, with an estimated 50,000 to 100,000 patients poisoned per year within the endemic area [1–3]. It is caused by ingesting fish contaminated with ciguatoxins produced by dinoflagellates of the genus Gambierdiscus [1–4]. Over 400 species of fish have been involved [2,4]. The objective of this study was to discuss the experience French Poison Control Centres (French PCCs) had of ciguatera over an 8-year period with patients poisoned in endemic areas (other countries or French overseas territories) or non-endemic (Mainland France) and to emphasize territorial differences in poisonings.
Ciguatera fish poisoning in the age of discovery and the age of enlightenment
Published in Clinical Toxicology, 2022
Ciguatera fish poisoning is widely regarded as the most common poisoning associated with seafood consumption [1,2]. Many estimates place the incidence at approximately 50,000 cases per year, but exact numbers are difficult to verify. Ciguatera generally occurs in latitudes between 35°N and 35°S with most reports arising from the South Pacific Ocean and the Caribbean Sea [1,2].