Neurotoxic shellfish poisoning: Difference between revisions
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==Background== | ==Background== | ||
[[File:Oysters of the day 01.jpg|thumb|Filter-feeding mollusks, such as oysters, concentrate dinoflagellates and their toxins in their flesh due to the way they feed. When the shellfish are then eaten by humans, high doses of the toxins may be consumed.]] | |||
*Associated with red tide | *Associated with red tide | ||
*Seen in Southeast US, Gulf of Mexico, Caribbean, New Zealand | *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<ref name=James> James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40. </ref> | *Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized<ref name=James> James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40. </ref> | ||
== | ==Clinical Features== | ||
* | ===Ingested=== | ||
*Similar to [[ciguatera]] | |||
*GI symptoms - [[vomiting]], [[diarrhea]], [[abdominal pain|abdominal cramping]]; usually within 30 minutes to 3 hours of ingestion | |||
*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> | |||
===Inhaled=== | |||
*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> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Marine envenomation DDX}} | {{Marine envenomation DDX}} | ||
== | ==Evaluation== | ||
*Based on symptoms and history of ingesting shellfish or proximity to red tide | |||
==Management== | |||
*Symptomatic | *Symptomatic | ||
==Disposition== | |||
==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]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Environmental]] | ||
Latest revision as of 18:02, 11 March 2021
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]
Clinical Features
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]
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
Evaluation
- Based on symptoms and history of ingesting shellfish or proximity to red tide
Management
- Symptomatic
Disposition
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.