Pufferfish Poisoning

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Medical Author:

Scott H Plantz, MD, FAAEM

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Pufferfish Poisoning Overview
• Pufferfish Poisoning Symptoms
• Pufferfish Poisoning Treatment
• When to Seek Medical Care
• Synonyms and Keywords
• Author and Editor

The poison found in pufferfish, blowfish, balloon fish, toads, sunfish, porcupine fish, toadfish, globefish, and swellfish is a tetrodotoxin. This is one of the most toxic poisons found in nature. Most people who eat pufferfish do so intentionally as pufferfish are considered an Asian delicacy, served in some types of sushi and sashimi. Unless the chef is specially trained to cut the meat in a particular fashion, however, the dish may contain a large amount of the toxin. Pufferfish poisoning is similar to paralytic shellfish poisoning.

• Symptoms generally occur 10-45 minutes after eating the pufferfish poison and begin with numbness and tingling around the mouth, salivation, nausea, and vomiting.
• Symptoms may progress to paralysis, loss of consciousness, and respiratory failure, and can lead to death.

• Vomiting should be induced if the poisoned person is awake and alert and has eaten the fish within 3 hours.
• The person may become paralyzed. Artificial respirations may keep the person alive until medical attention in a hospital's emergency department is possible.
• Rapidly turn the person onto his or her side if vomiting occurs.

Seek medical treatment as soon as possible.

wilderness: pufferfish poisoning, puffer fish poison, puffer fish toxin, pufferfish toxin, tetrodotoxin, poison, poisoning, blue-ringed octopus bite, food poisoning, fish poisoning

Author: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine.

Editor: William C. Shiel Jr., MD, FACP, FACR

REFERENCE:

MedscapeReference. Tetrodotoxin Toxicity.

Previous Contributing Editors: N Stuart Harris, MD, MFA, Staff Physician, Department of Emergency Medicine, Harvard Medical School; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; James Kimo Takayesu, MD, Staff Physician, Department of Emergency Medicine, Brigham and Women's Hospital/Massachusetts General Hospital.

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