Doctor's Notes on Clupeotoxin Poisoning
Clupeotoxin poisoning is a potentially fatal poisoning that occurs after eating fish contaminated with the toxin. The poison does not break down when the fish is cooked and 50% of people poisoned by clupeotoxin will die after ingesting it. Clupeotoxin is found in plankton-eating fish, such as anchovies, herring, sardines, bonefish, slickheads, and tarpons. These types of fish are most found in African, Caribbean, and Indo-Pacific coastal waters and is more commonly found in fish caught in the summer.
Symptoms of clupeotoxin poisoning begin 30-60 minutes after eating contaminated fish and may include
- abdominal pain,
- dry mouth,
- a metallic taste in the mouth,
- elevated heart and respiratory rate,
- blue tinge to lips/fingers/nose/toes,
- lightheadedness, and
- a drop in blood pressure.
What Is the Treatment for Clupeotoxin Poisoning?
Clupeotoxin poisoning symptoms can range from moderate to severe. Up to 50% of patients poisoned by clupeotoxin will die. If you suspect someone has been exposed to clupeotoxin poisoning, seek medical care immediately. There is no anti-toxin or antidote for clupeotoxin.
Treatment for clupeotoxin poisoning consists of supportive care such as:
- If the fish was eaten within 3 hours, induce vomiting
- Intravenous (IV) hydration
- Anti-nausea medication for prolonged nausea and vomiting after 4 hours
- Intravenous medications to increase blood pressure (pressors) such as norepinephrine, epinephrine, or dopamine
- Placing the patient on a ventilator to support breathing if the patient is in respiratory arrest or shock
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.