T61.02

Clinical Causes: Consumption of large predatory reef fish such as barracuda, grouper, red snapper, and moray eel that have accumulated ciguatoxins in their tissues. Contamination of marine environments by algae species like Gambierdiscus toxicus, which produce the toxins. Eating improperly prepared or undercooked fish which retains the toxins, as they are resistant to heat and cooking processes. Deliberate ingestion of contaminated fish as an act of self-harm, which may be motivated by mental health issues or other psychological factors.

Key Symptoms: Numbness or tingling sensations in the mouth, lips, tongue, or extremities. Gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal pain. Muscle weakness and fatigue. Dizziness or a sensation of lightheadedness. In some cases, painful cold sensations or altered temperature perception. Cardiovascular symptoms like slow heart rate or irregular heartbeat. In severe instances, neurological symptoms including headaches, visual disturbances, or even paralysis.

Diagnosis Path: Diagnosis of ciguatera fish poisoning is primarily based on clinical history, particularly recent consumption of reef fish in areas known for ciguatera outbreaks. Laboratory tests are not routinely used to confirm the presence of ciguatoxins in the body; instead, physicians rely on recognizing characteristic symptoms. In cases involving intentional self-harm, mental health assessments and psychiatric evaluations are crucial to determine underlying motives and provide appropriate care. Healthcare professionals may also investigate environmental exposure and dietary history to support the diagnosis.

Treatment Protocols: Supportive care with intravenous fluids to prevent dehydration. Medications such as analgesics to alleviate pain, anti-nausea drugs, and medications like mannitol in some cases to reduce neurological symptoms. Cooling measures or medications to manage abnormal temperature sensations. In cases of intentional self-harm, psychiatric intervention is essential, including counseling, therapy, and possibly medication to address underlying mental health conditions. Monitoring and managing cardiovascular symptoms as needed.