Tetrodotoxin: Difference between revisions

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==Background==
==Background==
*Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
*Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
**Heat-stable toxin not destroyed by washing, freezing or cooking
*Blocks neuronal action potential by blocking voltage-gated sodium channels
*Blocks neuronal action potential by blocking voltage-gated sodium channels
*Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity
*Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity (e.g. fugu restaurants)
[[File:Blue-ringed-octopus.jpeg|thumbnail]]
 
===Mechanism of Injury===
*Tetrodotoxin binds to and blocks fast-gated sodium channels, blocking conduction of nerve signals.


==Clinical Features==
==Clinical Features==
''Onset of symptoms usually within 30 min to 4 hours after eating pufferfish''
''Onset of symptoms usually within 30 min to 4 hours after eating pufferfish''
*Paresthesias
*Paresthesias, body numbness
*Dysarthria, dysphagia
*[[Headache]]
*[[Headache]]
*[[Vomiting]], [[diarrhea]], [[abdominal pain]]
*[[Vomiting]], [[diarrhea]], [[abdominal pain]]
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==Differential Diagnosis==
==Differential Diagnosis==
{{Marine envenomation DDX}}


==Evaluation==
==Evaluation==
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==Management==
==Management==
*Supportive care, intubate if concern for progressive paralysis
*Supportive care is mainstay of treatment
*Acetylcholinesterase inhibitors (e.g. [[neostigmine]])<ref>Tintanelli's</ref>
*May require intubation if concern for progressive paralysis
*[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])
 
==Disposition==
==Disposition==
*Admit, may need ICU
*Admit (may need ICU)
 
==External Links==
 
 
==See Also==
==See Also==
*[[Marine toxins and envenomations]]
*[[Marine toxins and envenomations]]
==External Links==


==References==
==References==
<references/>
<references/>
==Video==
{{#widget:YouTube|id=0DyrwwGQnlI}}
[[Category:Toxicology]]

Revision as of 06:42, 6 March 2019

Background

  • Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
    • Heat-stable toxin not destroyed by washing, freezing or cooking
  • Blocks neuronal action potential by blocking voltage-gated sodium channels
  • Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity (e.g. fugu restaurants)
Blue-ringed-octopus.jpeg

Mechanism of Injury

  • Tetrodotoxin binds to and blocks fast-gated sodium channels, blocking conduction of nerve signals.

Clinical Features

Onset of symptoms usually within 30 min to 4 hours after eating pufferfish

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

  • Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
  • Evaluate for other treatable causes of symptoms

Management

Disposition

  • Admit (may need ICU)

External Links

See Also

References


Video

{{#widget:YouTube|id=0DyrwwGQnlI}}