Poisoning syndrome | Affected seafood | Common geographic distribution | Primary toxin | Clinical findings | Management |
Paralytic shellfish poisoning | Bivalve mollusks* (Cockles, fresh- and salt-water mussels, little neck clams) | Worldwide, especially USA (Northeast, Pacific Northwest, and Alaska) | Saxitoxin | Perioral tingling Paresthesias Difficulty swallowing Dizziness Ataxia Paralysis | Supportive care Activated charcoal Mechanical ventilation for respiratory failure |
Neurotoxic shellfish poisoning | Bivalve mollusks (eg, mussels or clams) | Southeast USA Mexico Caribbean New Zealand | Brevetoxin | Ingestion:
Inhalation:
| Supportive care Ingestion:
Inhalation:
|
Diarrheic shellfish poisoning | Mussels | Japan Scandinavia France Belgium Spain Chile Uruguay Ireland Canada | Okadaic acid | Nausea Vomiting Diarrhea Abdominal pain | Supportive care Activated charcoal Antiemetics (eg, ondansetron) Fluid repletion |
Amnestic shellfish poisoning | Mussels Razor clams Crustaceans | Canada Spain Portugal France Ireland United Kingdom Peru Chile Australia New Zealand | Domoic acid | Diarrhea Abdominal pain Headache Disorientation Retrograde and anterograde memory loss Ophthalmoplegia Coma Seizures | Supportive care Activated charcoal Treat seizures with benzodiazepines (eg, lorazepam) |
Pufferfish poisoning | Pufferfish | Japan USA | Tetrodotoxin (liver) Saxitoxin (muscle) | Tetrodotoxin:
Saxitoxin:
| Tetrodotoxin:
Saxitoxin:
|
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