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PUFFER FISH (TETRODOTOXIN) POISONING CLINICAL RECORD AND SUGGESTED MANAGEMENT

Although the puffer fish is common in Australian waters, poisoning by its ichthyosarcotoxin, tetrodotoxin, is rare. Treatment must be directed towards maintaining the airway and ventilation, adequate circulation and renal function, and the management of cardiac dysrhythmias. A case report is presented, and it is noted that the patient retained consciousness despite total flaccid paralysis and unreactive pupils. The observation was made that recovery of muscle power was accelerated by administration of an anticholinesterase. An explanation for this is proposed.