Food Poisoning from Fish/Seafood

Food Poisoning from Fish/Seafood
Scombroid food poisoning
results from eating spoiled (decayed) fish — most commonly reported with mackerel, tuna , bluefish, mahi-mahi , bonito, sardines , anchovies , and related species of fish that were inadequately refrigerated or preserved after being caught.
most rapid onset; allergic symptoms — wheezing, flushing, rash; in severe cases – resp distress, blurred vision, tongue swelling
Tx: antihistamines (eg, DPH)
 
Ciguatera
is the most common nonbacterial foodborne illness caused by eating certain reef fish whose flesh is contaminated with toxins originally produced by dinoflagellates such as Gambierdiscus toxicus which live in tropical and subtropical waters.
Most commonly implicated fish are barracuda, red snapper, and grouper
Onset within 2-6 hours;
S/S – Neurological symptoms – paresthesias, numbness, weakness, reversal of heat and cold as well as nausea, vomiting, and abdominal cramps
Saxitoxin is the toxin found in shellfish that ingest particular dinoflagellates
The toxin affects neuronal transmission leading to symptoms of cranial nerve dysfunction and muscle weakness — high risk for respiratory failure
Tetrodotoxin is the toxin expressed by the puffer fish, a fish considered to be a delicacy in some eastern Asian countries
S/S-  perioral numbness, increasing neurologic dysfunction, and eventual respiratory arrest secondary to profound muscle weakness
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