Difference between revisions of "Neurotoxic shellfish poisoning"

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*Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized<ref name=James> James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.  </ref>
 
*Caused by brevetoxins secreted by dinoflagellates during algal blooms, which are then ingested by shellfish and/or aerosolized<ref name=James> James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.  </ref>
  
==Diagnosis==
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==Evaluation==
 
*Based on symptoms and history of ingesting shellfish or proximity to red tide
 
*Based on symptoms and history of ingesting shellfish or proximity to red tide
  
 
*If Ingested
 
*If Ingested
 
**Similar to [[ciguatera]]
 
**Similar to [[ciguatera]]
**GI symptoms - vomiting, diarrhea, abdominal cramping; usually within 30 minutes to 3 hours of ingestion
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**GI symptoms - [[vomiting]], [[diarrhea]], [[abdominal pain|abdominal cramping]]; usually within 30 minutes to 3 hours of ingestion
**Neurologic symptoms - parethesias, dizziness, ataxia. Can also see hot/cold temperature sensation reversal <ref name=Morris>Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4. </ref>
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**Neurologic symptoms - [[paresthesia]], [[dizziness]], [[ataxia]]. Can also see hot/cold temperature sensation reversal <ref name=Morris>Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4. </ref>
  
 
*If Inhaled
 
*If Inhaled
**Upper respiratory tract irritation, rhinorrhea, bronchoconstriction
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**Upper respiratory tract irritation, [[rhinorrhea]], [[bronchoconstriction]]
 
**Generally affects patients with chronic respiratory disease (ie asthma/COPD) <ref> Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187. </ref>
 
**Generally affects patients with chronic respiratory disease (ie asthma/COPD) <ref> Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187. </ref>
  
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==Prognosis==
 
==Prognosis==
 
*Most patients fully recover within 72 hours
 
*Most patients fully recover within 72 hours
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==See Also==
 
==See Also==
 
*[[Marine toxins and envenomations]]
 
*[[Marine toxins and envenomations]]

Latest revision as of 20:29, 22 October 2019

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

Differential Diagnosis

Marine toxins, envenomations, and bites

Management

  • Symptomatic

Prognosis

  • Most patients fully recover within 72 hours

See Also

References

  1. James KJ et al. Shellfish toxicity: human health implications of marine algal toxins. Epidemiol Infect. 2010;138(7):927-40.
  2. Morris PD et al. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am J Public Health. 1991;81(4):471-4.
  3. Fleming LE et al. Aerosolized red-tide toxins (brevetoxins) and asthma. Chest 2007;131:187.