Nazmul Ahasan H A M, Abdullah Al Mamun, Choudhury Habibur Rasul, Paritosh Kumar Roy, Gobinda Pada Paul, Chandra Shekhar Bala.
Puffer fish poisoning: A clinical analysis.
Pak J Med Sci Jan ;19(1):29-32.

Objective: To ascertain the clinical manifestations, complications and clinical outcome of Puffer fish poisoning. Setting: The study was carried out in the Department of Medicine and Paediatrics, Khulna Medical College Hospital (KMCH), Khulna, Bangladesh. The period of study ranged from admission of patients till discharge. Subjects and Methods: On April 18, 2002, a large number of patients from eight families were admitted to KMCH. A presumptive diagnosis of Puffer fish (tetrodotoxin) poisoning was made on the basis of history of recent consumption of Puffer fishes (Fugu) and classical clinical presentations. The cases were clinically reviewed periodically and routine investigations were done. Results: A total of forty-five persons developed manifestations of Puffer fish poisoning out of which thirty-seven needed hospitalizations. Important symptoms observed were peri-oral tingling sensation (24), weakness of both lower limbs (22), tingling and numbness throughout the body (18), headache (15) etc. Twenty-two patients developed ascending paralysis and 17 of them developed respiratory muscle paralysis. Out of thirty-seven admitted patients twenty-nine improved with conservative treatment. Eight patient died due to respiratory failure. Conclusion: Although Puffer fish is available in our country and Puffer fish poisoning is sporadic, ignorance regarding its proper cooking process may lead to serious clinical hazards including fatality. It has no specific treatment. Health personnel should have sufficient knowledge regarding its clinical manifestations, complications and management. People should be made aware of the potential risk of eating Puffer fish.

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