Neurotoxic shellfish poisoning: Difference between revisions
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*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>


==Evaluation==
==Clinical Features==
*Based on symptoms and history of ingesting shellfish or proximity to red tide
===Ingested===
 
*Similar to [[ciguatera]]
*If Ingested
*GI symptoms - [[vomiting]], [[diarrhea]], [[abdominal pain|abdominal cramping]]; usually within 30 minutes to 3 hours of ingestion
**Similar to [[ciguatera]]
*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>
**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>


*If Inhaled
===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>


==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==
==Management==
*Symptomatic
*Symptomatic
==Disposition==


==Prognosis==
==Prognosis==

Latest revision as of 18:02, 11 March 2021

Background

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
  • 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

Inhaled

Differential Diagnosis

Marine toxins, envenomations, and bites

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

  1. ↑ James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.
  2. ↑ Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4.
  3. ↑ Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187.
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