Paralytic Shellfish Poisoning

Etiology: induced by ingestion of contaminated filter-feeding organisms (e.g., clams, oysters, scallops, mussels) that concentrate water-soluble, heat- and acid-stable chemical toxins
- - The best-characterized and most frequently identified paralytic shellfish toxin is saxitoxin.
- - Paralytic shellfish toxins cannot be destroyed by ordinary cooking.
Clinical features: Oral paresthesias (initially tingling and burning, later numbness) develop within minutes to hours after ingestion of contaminated shellfish and progress to involve the neck and distal extremities. Flaccid paralysis and respiratory insufficiency may follow 2-12 h later; 12% of pts die, usually within 18 h.

Treatment: Paralytic Shellfish Poisoning

If pts present within hours of ingestion, gastric lavage and stomach irrigation with 2 L of a 2% sodium bicarbonate solution may be of benefit, as may administration of activated charcoal (50-100 g) and non-magnesium-based cathartics (e.g., sorbitol, 20-50 g).
The pt should be monitored for respiratory paralysis for at least 24 h.