Puffer fish poisoning: clinical features and management experience in 25 cases

Area of Science:

• Toxicology
• Clinical Medicine
• Public Health

Background:

• Puffer fish poisoning (PFP) is a serious health concern, particularly in regions where puffer fish consumption is prevalent.
• The neurotoxins in puffer fish, such as tetrodotoxin, can cause severe and potentially fatal symptoms.

Purpose of the Study:

• To analyze the clinical features, severity, and outcomes of puffer fish poisoning cases.
• To evaluate the effectiveness of supportive management strategies for PFP.

Main Methods:

• Retrospective analysis of 25 PFP cases admitted to Chon Buri Hospital between 1989 and 1999.
• Classification of poisoning severity into four stages based on clinical presentation.
• Review of treatment protocols, including gastric lavage, intravenous fluids, and mechanical ventilation.

Main Results:

• 25 cases of puffer fish poisoning (PFP) were identified, with 23 males and 2 females.
• Paresthesia was the initial symptom in all patients, followed by muscle weakness and, in 18 cases, acute flaccid paralysis and respiratory failure.
• All patients received supportive care, with 18 requiring mechanical ventilation, and all achieved complete recovery without sequelae.

Conclusions:

• Puffer fish poisoning presents with a range of neurological symptoms, including paralysis and respiratory compromise.
• Prompt and comprehensive supportive care, including ventilatory support when indicated, is crucial for favorable outcomes in PFP.
• Effective management strategies can lead to complete recovery from puffer fish poisoning, highlighting the importance of timely medical intervention.