Symptoms and Signs of Ciguatera Fish Poisoning
(Ciguatera Toxin)

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Doctor's Notes on Ciguatera Fish Poisoning
(Ciguatera Toxin)

Ciguatera is a type of food poisoning caused by eating fish contaminated by the ciguatera toxin found concentrated in fish organs. The toxin is commonly found concentrated in large reef fish, such as grouper, red snapper, sea bass, barracuda, eel, amberjack, and Spanish mackerel. Most fish that carry ciguatera toxin are found in the Caribbean Sea, Hawaii, and coastal Central America.

Symptoms of ciguatera fish poisoning (ciguatera toxin) usually begin 6 to 8 hours after eating contaminated fish but can occur anywhere from 2 to 24 hours after ingestion and include nausea, vomiting, diarrhea, muscle pain, numbness, tingling, abdominal pain, dizziness, spinning sensation (vertigo), feeling of hot and cold sensation reversal, and feeling of teeth being loose, and itching. Symptoms of severe ciguatera fish poisoning (ciguatera toxin) include shortness of breath, salivation, tearing, chills, rashes, itching, paralysis, slow heart rate, coma, and low blood pressure (hypotension).

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.