Fish/shellfish poisoning

Keywords: Ciguatera poisoning

Clinical Manifestations

Appropriate Tests


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



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

Paraesthesiae 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.

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