Puffer Fish Poisoning : Clinical Features and Manage ment Experience in 25 Cases

JIRASAK KANCHANAPONGKUL, M.D.*

Affiliation : * Department of Medicine, Chon Buri Hospital, Chon Buri 20000, Thailand.

AbstractBetween 1989 and 1999, 25 cases of puffur fish poisoning (PFP) were admitted to the medical service of Chon Buri Hospital. The severity of the poisoning was classified into four stages based on clinical signs and symptoms of PFP. Of the 25 patients, 23 were males and 2 were females. Three patients were in stage 1, four were in stage 2 and eighteen were in stage 4. Paresthesia was the early presenting complaint of all patients. Paresthesia consisting of either numbness or tingling of lips, tongue, around the mouth, hands, and feet. Muscle weakness, dizzi ness, vertigo, nausea and vomiting were common complaints. Eighteen patients developed acute flaccid paralysis and respiratory failure requiring ventilatory support. All patients received sympto matic and supportive treatment and general supportive care, including gastric lavage and intra venous fluid. Intubation and mechanical ventilation was considered especially when paralysis was progressing rapidly. Most were taken off the respirator 12-48 hours later. All patients completely recovered without any sequelae. Clinical features of PFP, toxicity of puffer fish and management were discussed.

Keywords : Puffer Fish Poisoning

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