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Cholestyramine improves tropical-related diarrhea
Rajesh Balagani1, Brandon Wills, Jerrold B Leikin
1Section of Critical Care, Department of Medicine, Northwestern Memorial Hospital, Chicago, IL 60026, USA.
American Journal of Therapeutics
|June 15, 2006
Summary
Pfiesteria toxin exposure can cause severe illness. Cholestyramine effectively treated secretory diarrhea, while diphenhydramine resolved headaches in a patient with suspected Pfiesteria intoxication after swimming in tropical waters.
Area of Science:
- Marine toxicology
- Environmental health
- Clinical medicine
Background:
- Pfiesteria dinoflagellate exposure causes illness with diarrhea, skin lesions, and neurological symptoms.
- Anion-exchange resin cholestyramine has shown promise in treating severe diarrhea from Pfiesteria intoxication.
Observation:
- A 54-year-old man developed skin irritation, headache, conjunctivitis, and severe watery diarrhea after swimming in "dirty ocean water" in the Dominican Republic.
- Physical exam revealed conjunctival injection and vesicular skin lesions. Stool studies were negative for pathogens.
- Intense diarrhea persisted despite initial treatments.
Findings:
- Cholestyramine administration (4 g PO tid) resolved the patient's severe diarrhea within 2 hours.
- Intravenous diphenhydramine (25 mg q 4 h) effectively treated the patient's persistent headache.
Implications:
- Cholestyramine and diphenhydramine may be effective treatments for specific symptoms of Pfiesteria intoxication.
- This case highlights the potential for marine toxins to cause significant human health issues.
- Prompt diagnosis and targeted treatment are crucial for managing Pfiesteria-related illnesses.
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