Brief ReportsTetrodotoxin poisoning☆,☆☆
Section snippets
Case reports
On April 17, 2001, six Chinese fishermen ingested puffer fish (later identified as Lagocephalus lunaris [Bloch & Schneider] by photography) on their boat in the Taiwan Strait. They experienced orolingual numbness, acroparesthesia, and breathlessness approximately 2 to 3 hours after ingestion. They were evacuated by helicopter and were dispatched to three hospitals in the Chiayi area, the southern part of Taiwan. All six patients were middle-aged men. The clinical presentations of these patients
Discussion
In this study, six cases of TTX poisoning with a variety of clinical presentations is reported. All were middle-aged men. One patient was dead on arrival because of delay in transportation and initial resuscitation. After successful resuscitation, he regained his spontaneous circulation but developed a complete atrioventricular block soon after initial stabilization. This patient died 1 day after admission as a result of intractable bradycardia and multiple organ failure despite intravenous
Conclusion
TTX poisoning, although uncommon, is frequently seen in Taiwan, Japan, and Southeast Asia. It is rare but significant in the United States. A favorable outcome can be obtained if aggressive supportive treatment is provided in time in most patients. Thus, appropriate prehospital and ED ventilatory support (the implementation of a bag-valve mask or endotracheal intubation with good ventilatory support) are mandatory for those patients with respiratory failure. Most patients have their symptom
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Address reprint requests to Chii-Hwa Chern, MD, Emergency Department, Veterans General Hospital-Taipei, Taiwan, R.O.C, E-mail: [email protected]
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