Volume 73, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


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  1. Hughes JM, Merson MH, 1976. Current concepts fish and shellfish poisoning. N Engl J Med 295 : 1117–1120.
    [Google Scholar]
  2. Rakita RM, 1995. Ciguatera poisoning. J Travel Med 2 : 252–254.
    [Google Scholar]
  3. Schnorf H, Taurarii M, Cundy T, 2002. Ciguatera fish poisoning: a double-blind randomized trial of mannitol therapy. Neurology 58 : 873–880.
    [Google Scholar]
  4. Raikhlin-Eisenkraft B, Bentur Y, 2002. Rabbitfish (“aras”): an unusual source of ciguatera poisoning. Isr Med Assoc J 4 : 28–30.
    [Google Scholar]
  5. Ting JY, Brown AF, 2001. Ciguatera poisoning: a global issue with common management problems. Eur J Emerg Med 8 : 295–300.
    [Google Scholar]
  6. Bagnis R, Kuberski T, Laugier S, 1979. Clinical observations on 3009 cases of ciguatera (fish poisoning) in the South Pacific. Am J Trop Med Hyg 28 : 1067–1073.
    [Google Scholar]
  7. Pottier I, Vernoux JP, Lewis RJ, 2001. Ciguatera fish poisoning in the Caribbean islands and Western Atlantic. Rev Environ Contam Toxicol 168 : 99–141.
    [Google Scholar]
  8. Yasumoto Y, 1991. Ciguateric toxins. Food Hygiene Examination Manual. Tokyo: Japan Food Hygiene Association, 309–312.
  9. Lewis RJ, Sellin M, 1991. Purification and characterization of ciguatoxins from moray eel (Lycodontis javanicus, Muraenidae). Toxicon 29 : 1115–1127.
    [Google Scholar]
  10. Lehane L, Lewis RJ, 2000. Ciguatera: recent advances but the risk remains. Int J Food Microbiol 61 : 91–125.
    [Google Scholar]
  11. Butera R, Prockop LD, Buonocore M, Locatelli C, Gandini C, Manzo L, 2000. Mild ciguatera poisoning: Case reports with neurophysiological evaluations. Muscle Nerve 23 : 1598–1603.
    [Google Scholar]
  12. Miller RM, Pavia S, Keary P, 1999. Cardiac toxicity associated with ciguatera poisoning. Aust N Z J Med 29 : 373–374.
    [Google Scholar]
  13. Karalis T, Gupta L, Chu M, Campbell BA, Capra MF, Maywood PA, 2000. Three clusters of ciguatera poisoning: clinical manifestations and public health implications. Med J Aust 172 : 160–162.
    [Google Scholar]
  • Received : 26 Feb 2004
  • Accepted : 27 Jul 2005
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