Short report: persistent bradycardia caused by ciguatoxin poisoning after barracuda fish eggs ingestion in southern Taiwan.
We report an outbreak of ciguatoxin poisoning after barracuda fish ingestion in southern Taiwan. Three members of a family developed nausea, vomiting, watery diarrhea, and myalgias about 1 hour after eating three to ten eggs of a barracuda fish. Numbness of the lips and extremities followed the gastrointestinal symptoms about 2 hours after ingestion. Other manifestations included hyperthermia, hypotension, bradycardia, and hyperreflexia. Bradycardia persisted for several days, and one patient required a continuous infusion of intravenous atropine totaling 40 mg over 2 days. Further follow-up of the patients disclosed improvement of neurologic sequelae and bradycardia, but sensory abnormalities resolved several months later. In conclusion, ciguatoxin poisoning causes mainly gastrointestinal and neurologic effects of variable severity. In two patients with ciguatoxin poisoning after barracuda fish egg ingestion, persistent bradycardia required prolonged atropine infusion.
Hung
Yao-Min
YM
Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, Taiwan. ymhung1@doctor.com
Hung
Shih-Yuan
SY
Chou
Kang-Ju
KJ
Huang
Neng-Chyan
NC
Tung
Chung-Ni
CN
Hwang
Deng-Fwu
DF
Chung
Hsiao-Min
HM
D000368:Aged; D000818:Animals; D001919:Bradycardia / Q000209:etiology*; D036841:Ciguatera Poisoning / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D002922:Ciguatoxins / Q000032:analysis; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D005260:Female; D005399:Fishes; D005506:Food Contamination; D006801:Humans; D008297:Male; D008875:Middle Aged; D017747:Seafood; D013624:Taiwan / Q000453:epidemiology
D002922:Ciguatoxins