Revision as of 12:20, 20 December 2012 by Rossdonaldson1 (talk | contribs) (Source)


  • Most cases tropics and subtropics, between 35 degrees north and south latitudes
  • Most common fish are barracuda, moray eel, amberjack, and certain types of grouper, mackerel, parrotfish, and red snapper
  • Caused by fish eating dinoflagellates that grow on and around coral reefs and contain a heat-stable toxin


  • GI symptoms
    • vomiting, diarrhea, and abdominal cramping
    • 3-30hrs after eating contaminated fish
  • Neurologic symptoms
    • Paresthesias, painful teeth, painful urination, blurred vision, nerve palsies, and hot/cold temperature reversal
  • Cardiovascular symptoms
    • Bradycardia, heart block, and hypotension.

^Diagnosis based on history and physical only


  • Symptomatic
  • Prevent recurrances
    • Do not injest alcohol, caffeine, nuts or fish for 6 months


  • Neurologic symptoms typically persist from a few days to several weeks
  • ~20% of patients have symptoms that persist for months
  • <2% have symptoms that last for years

See Also