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Am. J. Trop. Med. Hyg., 73(6), 2005, pp. 1026-1027
Copyright © 2005 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


PERSISTENT BRADYCARDIA CAUSED BY CIGUATOXIN POISONING AFTER BARRACUDA FISH EGGS INGESTION IN SOUTHERN TAIWAN

YAO-MIN HUNG*, SHIH-YUAN HUNG, KANG-JU CHOU, NENG-CHYAN HUANG, CHUNG-NI TUNG, DENG-FWU HWANG, AND HSIAO-MIN CHUNG
Division of Nephrology, Department of Medicine, and Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung; Division of Nephrology, E-Da Hospital, I-Shou University, Kaohsiung; Department of Food Science, National Taiwan Ocean University, Keelung; and National Yang-Ming University, School of Medicine, Taipei, Taiwan

 

ABSTRACT

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.

Received February 26, 2004. Accepted for publication July 27, 2005.

Acknowledgment: The authors deeply thank Professor Kent R. Olson for his valuable comments and grammatical revision of this manuscript.

* Address correspondence to Yao-Min Hung, Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan. E-mail: ymhung1{at}doctor.com

Authors’ addresses: Yao-Min Hung, Kang-Ju Chou, Neng-Chyan Huang, Chung-Ni Tung, and Hsiao-Min Chung, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaosiung 813, Taiwan, Telephone: 886-7-3422121, ext. 2050, Fax: 886-7-3455412, E-mail: ymhung1{at}doctor.com. Shih-Yuan Hung, E-Da Hospital, 1 Eda Road, Yanchou Hsiang, Kaohsiung County 824, Taiwan. Deng-Fwu Hwang, National Taiwan Ocean University, 2 Pei-Ning Road, Kee-lung 202, Taiwan.

Reprint requests: Yao-Min Hung, Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan. Telephone: 886-7-3422121 ext 2050, Fax: 886-7-3455412, E-mail: ymhung1{at}doctor.com.






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Copyright © 2005 by the American Society of Tropical Medicine and Hygiene.