UMEM Educational Pearls

Category: Toxicology

Title: Tetrodotoxin Outbreak - in Minnesota!

Keywords: tetrodotoxin (PubMed Search)

Posted: 1/29/2015 by Fermin Barrueto, MD (Updated: 9/23/2019)
Click here to contact Fermin Barrueto, MD

Tetrodotoxin is lethal poison that blocks sodium channels. A famous sushi called "Fugu" is cut from a puffer fish that contains this poison. The idea is to get just enough of the toxin to cause peri-oral paresthesia but not too much to get seizures, paralysis and cardiac dysrrhythmias. A recent outbreak in Minneapolis, Minnesota was just reported in the MMWR so it can really happen anywhere, its a great read - dried puffer was bought from a market in NYC.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6351a2.htm

2-3 mg of the toxin is lethal to an adult human. No antidote exists though I would try hypertonic sodium bicarbonate for the cardiac dysrrhythmias and appropraite supportive. If the patient survives 24 hrs, the patient will do well without sequelae if appropriately supported.