Infectious Disease Compendium

Paralytic Shellfish Poisoning

Diagnosis

Tingling of the lips and tongue, progressing to tingling of fingers and toes and then progressive paralysis. Death can occur in two hours.

Epidemiologic Risks

Eating contaminated shellfish from colder coastal waters of the Pacific states and New England, it has been reported in Central America.

Shellfish include mussels, cockles (a heart-shaped mollusk that can warm parts of your heart), clams, scallops, oysters, crabs, and lobsters.

Also some pufferfish.

Microbiology

From the algae Alexandrium (a dinoflagellate) that collects in shellfish. Alexandrium makes saxitoxin, a neurotoxin, that is heat and acid-stable, and ordinary cooking methods do not inactivate the toxins. It is a selective sodium channel blocker.

Empiric Therapy

Supportive.

Pearls

Botulism, Tick paralysis and Guillain Barre Syndrome are in the differential diagnosis.

May be a cause of death in sea otters, seals, and whales.

Rants

I do not consider this an infectious disease.

Last Update: 12/12/18.


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