ciguatoxins and Coma

A few days after a seafood meal a patient suffered ataxia and stupor. His examination revealed a confused patient with cerebellar signs and ocular disturbances (hypotropia). Blood results, cerebrospinal fluid and brain CT scan were unremarkable. The patient developed a septic shock and died 4 weeks after admission. No necropsy was performed. Questioning his family confirmed that he had eaten a shellfish meal a few hours before onset of the digestive signs. Trocas (Tectus pyramis) were definitely identified. The clinical picture strongly suggested a seafood poisoning, namely ciguatera. However, no toxicologic assay was performed. To our knowledge, this poisoning has never been reported with trocas. Nevertheless, the feeding habits of trocas would suggest similarity with ciguatera poisoning.

Topics: Adult; Ataxia; Ciguatoxins; Coma; Fatal Outcome; Humans; Male; Seafood; Shellfish; Shock, Septic

A patient is presented who developed an acute gastrointestinal and neurologic syndrome progressing to coma after ingestion of a fish soup made in Rhode Island. Laboratory studies confirmed the clinical diagnosis of ciguatera poisoning. Physicians should be aware of the diagnostic features of this disease even in non-endemic areas.

Topics: Animals; Ciguatera Poisoning; Ciguatoxins; Coma; Fishes; Guinea Pigs; Humans; Male; Mice; Middle Aged; Rhode Island