Neurotoxic shellfish poisoning: Difference between revisions
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*If Ingested | *If Ingested | ||
**Similar to [[ciguatera]] | **Similar to [[ciguatera]] | ||
**GI symptoms - vomiting, diarrhea, abdominal cramping; usually within 30 minutes to 3 hours of ingestion | **GI symptoms - [[vomiting]], [[diarrhea]], [[abdominal pain|abdominal cramping]]; usually within 30 minutes to 3 hours of ingestion | ||
**Neurologic symptoms - | **Neurologic symptoms - [[paresthesia]], [[dizziness]], [[ataxia]]. Can also see hot/cold temperature sensation reversal <ref name=Morris>Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4. </ref> | ||
*If Inhaled | *If Inhaled | ||
**Upper respiratory tract irritation, rhinorrhea, bronchoconstriction | **Upper respiratory tract irritation, rhinorrhea, [[bronchoconstriction]] | ||
**Generally affects patients with chronic respiratory disease (ie asthma/COPD) <ref> Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187. </ref> | **Generally affects patients with chronic respiratory disease (ie asthma/COPD) <ref> Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187. </ref> | ||
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==Prognosis== | ==Prognosis== | ||
*Most patients fully recover within 72 hours | *Most patients fully recover within 72 hours | ||
==See Also== | ==See Also== | ||
*[[Marine toxins and envenomations]] | *[[Marine toxins and envenomations]] | ||
Revision as of 21:27, 28 September 2019
Background
- Associated with red tide
- Seen in Southeast US, Gulf of Mexico, Caribbean, New Zealand
- Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized[1]
Evaluation
- Based on symptoms and history of ingesting shellfish or proximity to red tide
- If Ingested
- Similar to ciguatera
- GI symptoms - vomiting, diarrhea, abdominal cramping; usually within 30 minutes to 3 hours of ingestion
- Neurologic symptoms - paresthesia, dizziness, ataxia. Can also see hot/cold temperature sensation reversal [2]
- If Inhaled
- Upper respiratory tract irritation, rhinorrhea, bronchoconstriction
- Generally affects patients with chronic respiratory disease (ie asthma/COPD) [3]
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
Management
- Symptomatic
Prognosis
- Most patients fully recover within 72 hours
See Also
References
- ↑ James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.
- ↑ Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4.
- ↑ Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187.