Fish/shellfish poisoning

Last updated: Tuesday, 03, August, 2010
Clinical ManifestationsAppropriate Tests

Ciguatera

Diagnosis by detection of ciguatoxin in suspect fish eg, barracuda, snapper (specialised laboratory). The symptoms may take months to resolve.

Abdominal cramps

  • Nausea, vomiting, diarrhoea
  • Numbness of lips, mouth
  • Hot-cold temperature reversal
  • Shooting pains
  • Respiratory paralysis

Scombroid

Clinical diagnosis with history of ingestion of spoiled (decayed)fish eg, tuna, mackerel.
  • Histamine reaction

Shellfish poisoning

Clinical syndromes due to dinoflagellate toxins which are concentrated by the shellfish.
  • Paralytic
Paraesthesiae and muscle weakness; diagnosis by detection of saxitoxin from eg, Gonyaulax sp, in suspect shellfish.
  • Neurotoxic
Parasthesiae without muscle weakness, due to unspecified toxins in Gymnodinium breve
  • Amnesic
Amnesia and confusion, at times with cardiovascular instability due to domoic acid produced by Nitzchia pungens.