Diferencia entre revisiones de «Tetrodotoxin»
| Línea 22: | Línea 22: | ||
==Management== | ==Management== | ||
*Supportive care, intubate if concern for progressive paralysis | *Supportive care, intubate if concern for progressive paralysis | ||
*Acetylcholinesterase inhibitors (e.g. [[neostigmine]])<ref>Tintanelli's</ref> | *[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])<ref>Tintanelli's</ref> | ||
==Disposition== | ==Disposition== | ||
*Admit, may need ICU | *Admit, may need ICU | ||
Revisión del 04:58 5 oct 2016
Background
- Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
- Blocks neuronal action potential by blocking voltage-gated sodium channels
- Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity
Clinical Features
Onset of symptoms usually within 30 min to 4 hours after eating pufferfish
- Paresthesias
- Headache
- Vomiting, diarrhea, abdominal pain
- Ascending paralysis
- Respiratory failure
- Death
Differential Diagnosis
Marine toxins, envenomations, and bites
- Toxins
- Ciguatera
- Scombroid
- Tetrodotoxin (e.g. pufferfish)
- Shellfish poisoning
- Amnesic shellfish poisoning
- Diarrheal shellfish poisoning
- Neurotoxic shellfish poisoning
- Paralytic shellfish poisoning
- Stingers
- Venomous fish
- Cone shell
- Lionfish
- Sea urchins
- Crown-of-Thorns Starfish
- Stonefish
- Other: Catfish, zebrafish, scorpion fish
- Nematocysts
- Coral reef
- Fire coral
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Sea anemones
- Seabather's eruption
- Phylum porifera (sponges)
- Bites
- Infections
Evaluation
- Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
- Evaluate for other treatable causes of symptoms
Management
- Supportive care, intubate if concern for progressive paralysis
- Acetylcholinesterase inhibitors (e.g. neostigmine)[1]
Disposition
- Admit, may need ICU
See Also
External Links
References
- ↑ Tintanelli's