tag:blogger.com,1999:blog-364516522011-11-17T10:07:41.931-08:00Miguel G. Madariagahttp://www.blogger.com/profile/09654718100569863751noreply@blogger.comBlogger11100tag:blogger.com,1999:blog-36451652.post-68228302206508520882011-11-17T10:06:00.000-08:002011-11-17T10:07:41.964-08:00A 52-year-old residing in Metlakatla, on Annette Island in southeast Alaska, awoke from a nap with numbness around his mouth, tingling in his hands, and slight dyspnea after eating non-commercially harvested seafood recently. The most likely diagnosis is:<br />a. Ciguatera poisoning<br />b. Paralytic shellfish poisoning<br />c. Neurotoxic shellfish poisoning<br />d. Amnesic shellfish poisoning<br />e. Azaspiracid shellfish poisoning<br /><br />Scroll down for the answer<br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />Answer: B<br />Paralytic shellfish poisoning occurs in the continental US and Alaska. It is caused by shellfish containing saxitoxin (which commercially harvested seafood is tested for). The manifestations include circumoral paresthesias, paresthesias of the extremities, ataxia, dysphagia and respiratory failure. Neurotoxic shellfish poisoning may cause similar symptoms but is caused by ingestion contaminated by brevetoxins in Florida.<br />Ciguatera fish poisoning is caused by ingestion of large reef fish (such as barracuda). The disease occurs in the South Pacific and the Caribbean region. Symptoms include nausea, vomiting , diarrhea, headache, dysesthesia, hemodynamic inastibility and occasionally respiratory difficulties.<br />Amnesic shellfish poisoning is associated with loss of short memory and it has been reported in Canada. Azaspiracid shellfish poisoning is a diarrheal illness described in the Netherlands and caused by azaspiracid (a toxin different from okadaic acid, the cause of the more widely distributed diarrhetic shellfish poisoning.<br />Reference: CDC. Paralytic Shellfish Poisoning — Southeast Alaska, May–June 2011. MMWR 60;45: 1554-56.<div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/36451652-6822830220650852088?l=mandingamajor.blogspot.com' alt='' /></div>Miguel G. Madariagahttp://www.blogger.com/profile/09654718100569863751noreply@blogger.com