Paralytic shellfish poisoning

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Paralytic shellfish poisoning
Chemical structure of saxitoxin
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Nausea, vomiting, diarrhea, abdominal pain, paresthesia, muscle weakness, respiratory failure
Complications	Respiratory arrest, death
Onset	Minutes to hours after consumption
Duration	Hours to days
Types	N/A
Causes	Consumption of shellfish contaminated with saxitoxin
Risks	Eating shellfish from affected waters
Diagnosis	Clinical evaluation, history of shellfish consumption
Differential diagnosis	Ciguatera, neurotoxic shellfish poisoning, amnesic shellfish poisoning
Prevention	Avoiding shellfish from affected areas
Treatment	Supportive care, mechanical ventilation if needed
Medication	N/A
Prognosis	Good with prompt treatment
Frequency	Varies by region and season
Deaths	N/A

Paralytic shellfish poisoning (PSP) is a serious illness caused by consuming shellfish contaminated with dinoflagellate algae that produce harmful toxins. These toxins can cause paralysis and even death in humans.

Causes

PSP is primarily caused by the consumption of shellfish that have ingested the marine dinoflagellate algae, Alexandrium spp., Gymnodinium catenatum, and Pyrodinium bahamense. These algae produce a group of neurotoxins known as saxitoxins.

Symptoms

Symptoms of PSP can occur within minutes to hours after consuming contaminated shellfish. Initial symptoms often include tingling of the lips and tongue, which may begin to spread to the face and neck. Paralysis and respiratory failure can occur in severe cases, leading to death.

Diagnosis

Diagnosis of PSP is typically based on the patient's symptoms and recent dietary history. Laboratory testing can be done to detect the presence of saxitoxins in the patient's blood or in leftover food.

Treatment

There is no specific antidote for PSP. Treatment is supportive and aims to manage symptoms. This may include respiratory support in severe cases.

Prevention

Prevention of PSP involves monitoring of shellfish and water for the presence of harmful algae and toxins. Public health advisories and closures of shellfish beds are often implemented during harmful algal blooms to prevent human exposure to the toxins.

See also

• Shellfish poisoning
• Harmful algal bloom
• Saxitoxin
• Dinoflagellate

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