Paralytic complications of puffer fish (tetrodotoxin) poisoning.
BACKGROUND
Puffer fish is available in Bangladesh and is occasionally eaten by some people. Ignorance regarding its proper cooking process may lead to serious health hazards, including fatality.


METHODS
An unusual catastrophic event happened recently in Khulna, Bangladesh that drew nationwide attention. Eight families were affected.


RESULTS
Thirty-seven patients were admitted with a history of consumption of puffer fish. Peri-oral paraesthesia (24), weakness of both lower limbs (22), paraesthesia all over the body (18), headache (15), difficulty in respiration (14), nausea and vomiting (8), blurring of vision (7), and vertigo (6) were common clinical presentations. Twenty-two patients developed ascending paralysis of limbs and involved the respiratory muscles in 17 patients. Eight patients died due to respiratory failure while the rest improved.


CONCLUSIONS
Health personnel should have sufficient knowledge regarding the clinical manifestations, complications and management of puffer fish poisoning. During its preparation, organs that contain the highest level of tetrodotoxin should be removed. Since there is no specific treatment, people should be made aware of the potential risk of eating puffer fish, about the warning symptoms and signs of puffer fish poisoning, and when to seek medical help.
Department of Medicine, Khulna Medical College, Khulna 9000, Bangladesh. supto@bttb.net.bd
H A M N
HA
Ahasan
A A
AA
Mamun
S R
SR
Karim
M A
MA
Bakar
E A
EA
Gazi
C S
CS
Bala
D000818:Animals; D005260:Female; D005400:Fishes, Poisonous; D005517:Foodborne Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D010292:Paresthesia / Q000209:etiology*; D023721:Tetraodontiformes; D013779:Tetrodotoxin / Q000506:poisoning*
D013779:Tetrodotoxin