ABSTRACT
BACKGROUND: Tetrodotoxin is considered the most lethal toxin in the marine environment. Prior cases of intoxication previously described correspond to consumption of tetrodotoxin in tropical or subtropical regions of Asia or the Pacific Islands. OBJECTIVES: We present the first European case of tetrodotoxin intoxication in a patient who ingested part of a trumpet shellfish (Charonia sauliae) from the Atlantic Ocean in Southern Europe. CASE REPORT: Our patient suffered general paralysis, including the respiratory muscles, a few minutes after the consumption of a few grams of C. sauliae. Intubation and mechanical ventilation were necessary for 52 h after the intoxication. The corresponding electrophysiologic studies showed complete non-excitability, with no recordable sensory or motor nerve conduction. We detected the presence of tetrodotoxin in the mollusk and the patient's blood and urine by means of high-performance liquid chromatography-mass spectrometry analysis technique. A previous bioassay showed extremely high quantities of the toxin in the mollusk. CONCLUSIONS: This case alerts us to the possibility of a very harmful biotoxin in European coastal waters. This now should be included in the differential diagnosis of similar cases in Europe, and we must be vigilant for its possible presence in Europe.
Subject(s)
Mollusk Venoms/poisoning , Paralysis/chemically induced , Shellfish Poisoning/etiology , Sodium Channel Blockers/poisoning , Tetrodotoxin/poisoning , Chromatography, Liquid/methods , Electroencephalography , Europe , Humans , Male , Mass Spectrometry/methods , Middle Aged , Respiration, Artificial , Respiratory Muscles/drug effects , Shellfish Poisoning/therapyABSTRACT
Se presenta el caso de un paciente con intoxicación paralítica por ingesta de moluscos que cursó con insuficiencia respiratoria grave y requirió ventilación mecánica durante48 horas. Se trata de una intoxicación muy rara en nuestro entorno y puede ocasionarla muerte por parálisis de los músculos respiratorios si no se atiende adecuadamente (AU)
We report the case of a man with paralytic poisoning caused by eating mollusks. The patient presented with severerespiratory failure and required mechanical ventilation for 48 hours. This syndrome, which is very rare in Spain, can befatal if the respiratory muscles are affected and proper treatment is not provided (AU)
