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General Reference ⬇

Nejm 1991;324:716

Pathophys and Cause ⬆ ⬇

Cause:Ingestion usually of spoiled tuna, mackerel, bonito, bluefish, mahi mahi, et al.

Epidemiology ⬆ ⬇

Most common type of fish poisoning in US

Signs and Symptoms ⬆ ⬇

Sx + Si:Peppery metallic taste to fish when eaten; headache, flushing, diarrhea within 10-30 min of ingestion; cooking does not prevent

Course ⬆ ⬇

3 h without rx; faster with rx

Complications ⬆ ⬇

r/oCIGUATERA (FISH) POISONING (Ann IM 1995;122:113) from dinoflagellate ingestion by fish; cooking does not prevent; sx of diarrhea, neuralgias, "loose teeth," dysphagia, loss of temperature sensation, et al., may last mos-yrs; rx like red tide poisoning (see Neurotoxic Shellfish Poisoning)

Treatment ⬆

Rx:Diphenhydramine (Benadryl) 50 mg iv/im/po