1 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
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.
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: firstname.lastname@example.org.
Copyright 2005 The American Society of Tropical Medicine 2005