Puffer Fish Poisoning : A Review of 29 Cases at Chon Buri Hospital - พิษปลาปักเป้า : ทบทวนผู้ป่วย 29 รายในโรงพยาบาลชลบุรี

Abstract

        Between 1989 and 2008, 29 cases of marine puffer fish poisoning, were admitted to the medical service of Chon Buri Hospital. The frequencies of symptoms and signs included circumoral and lingual numbness (100%), hand and feet numbness (100%), limb weakness (89.6%), dizziness and vertigo (75.8%) speech difficulty and dysphagia (68.9%), respiratory paralysis (68.9%), nausea and vomiting (65.5%), transient hypertension (34.4%), fixed dilated pupils (34.4%) ophthalmoplegia (34.4%), and blood pressure lower than 90/60 mm Hg (6.9%) All patients received symptomatic and supportive treatments. Endotracheal intubation and mechanical ventilation were considered once paralysis was progressing rapidly. All patients showed complete recovery without any sequelae. People should be made aware of the potential risk of eating puffer fish, about the warning symptoms and signs of puffer fish poisoning. Health personnel should have sufficient knowledge regarding the clinical manifestations and management of puffer fish poisoning.
Key words: puffer fish poisoning, tetrodotoxin, saxitoxin