Ciguatera Poisoning.
Ciguatera poisoning is a worldwide problem associated with ingestion of certain toxin-containing fish. The disease was named after a turban-shelled snail known as "cigua" in the Spanish Antilles, which was mistakenly thought to be the cause of this disease.1 More than 200 species of fish have been implicated, the most common of which include grouper, red snapper, barracuda, amberjack, and less commonly mackerel, surgeonfish, and sea bass. Toxin-containing fish may be found in tropical areas extending approximately 35 degrees latitude on either side of the equator, but the increase in air travel and the relative ease of shipping fish long distances have meant that both travelers and people living outside those areas may be affected.2 In major endemic areas, including the Caribbean and the South Pacific islands, the incidence of ciguatera poisoning ranges from 50-500 cases annually per 10,000 population, making it one of the more common illnesses in those areas. I report two cases of ciguatera poisoning in a husband and wife following barracuda ingestion and briefly review the clinical manifestations, diagnosis, and treatment of this disease.
Rakita
RM
Assistant Professor of Medicine, Center for Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, Texas.