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Neurotoxic shellfish poisoning
From WikEM
Contents
Background
- Associated with red tide
- Seen in Southeast US, Gulf of Mexico, Caribbean, New Zealand
- Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized[1]
Evaluation
- Based on symptoms and history of ingesting shellfish or proximity to red tide
- If Ingested
- If Inhaled
- Upper respiratory tract irritation, rhinorrhea, bronchoconstriction
- Generally affects patients with chronic respiratory disease (ie asthma/COPD) [3]
Differential Diagnosis
Marine toxins and envenomations
- Toxins
- Scombroid
- Ciguatera
- Neurotoxic shellfish poisoning
- Paralytic shellfish poisoning
- Tetrodotoxin (e.g. pufferfish)
- Stingers
- Venomous fish (catfish, zebrafish, scorpion fish, stonefish)
- Lionfish
- Sea urchins
- Cone shells
- Nematocysts
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Coral reef
- Fire Corals
- Sea anemones
- Sea wasps
- Bites
Management
- Symptomatic
Prognosis
- Most patients fully recover within 72 hours
See Also
References
- ↑ James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.
- ↑ Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4.
- ↑ Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187.
