Doctor's Notes on Ciguatera Fish Poisoning
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).
Ciguatera Fish Poisoning
(Ciguatera Toxin) Symptoms
Eating ciguatera toxin contaminated fish result in the following symptoms:
- Symptoms generally begin 6 to 8 hours after eating the contaminated fish but can occur as early as 2 or as late as 24 hours after ingestion.
- Symptoms include nausea, vomiting, diarrhea, muscle pain, numbness, tingling, abdominal pain, dizziness, and vertigo. The classic finding of hot and cold sensation reversal is actually a burning sensation on contact with cold (allodynia).
- Teeth may feel loose and itching may be intense.
- Severe cases of ciguatera poisoning may result in shortness of breath, salivation, tearing, chills, rashes, itching, and paralysis. Bradycardia, coma and hypotension can occur. Death due to poisoning is rare (less then 0.5 %).
Listeria bacteria can contaminate fresh produce, like cantaloupes, as well as some processed foods, like cheeses. Symptoms of infection include fever, muscle aches, upset stomach, or diarrhea -- occurring 2 days to 2 months after exposure.
Safety: Scrub raw produce and dry before cutting. Store in fridge below 40 F. Clean everything in contact with a whole melon.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.