Fresh Water Puffer Fish Poisoning
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Abstract
Objective: To study the clinical symptoms and signs of the patients who diagnosed as fresh water puffer fish poisoning.
Study design: descriptive, retrospective study.
Patients and method: All patients who diagnosed as fresh water puffer fish poisoning in Medical Department, Sisaket Hospital from January 2009 to January 2012 were reviewed about the clinical symptoms and signs
Results: There were fourteen patients who diagnosed as fresh water puffer fish poisoning. Male was predominate. The seven patients were found during September and December. There were eleven patients developed neurological symptoms and signs within 6 hours after puffer fish ingestion. All of them described generalize hypoesthesia, thirteen patients described perioral numbness and ten patientsdeveloped motor power weakness. There were seven patients received ventilator supporting care because of acute respiratory failure and five of them were improved within 72 hours. There were two patients with acute respiratory failure developed hospital acquired pneumonia, their clinical symptom was improved after appropriated antibiotic treatment. Most of the patients were getting better within a few day after the supportive and symptomative treatment. There was one patient died of cardiopulmonary failure.
Conclusion: Fresh water puffer fish poisoning was mostly reported in the Northeast Thailand. The eurological symptoms and signs consist of both motor paralysis and hypoesthesia. Those caused by Paralytic shellfish poisons stored in fresh water puffer fish. It is not Tetrodotoxin as found in marine puffer fish.The pathophysiology of neurological involvement is the same mechanism. Nowadays, there is not antidote to the both toxins. Most of the patients will be getting better within 24-48 hours after the supportive and symptomative treatment.
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References
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