doc_clotaire
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A 52 yo woman presnet to the ER 5 h after eating some grouper at a seafood restaurant while on vacation in Hawai . She has abdominal cramps , nausea , vomiting and watery diarrhea . She also complains of tingling and numbness of her lips and extremities . PE reveals a fine tremor and some mild ataxia . Which of the following is the most likely diagnostic in his patient ?
a ) Ciquatera poisonning
b ) Scromboid posonning
c ) Hemolytic uremic syndrome
d ) Traveler 's diarrhea
e ) Mycobacterium marinum
f ) Campylobacter jejuni
g ) Vibrio parahemofilus
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| aaroho
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B-scromboid poisoning
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| neuroblastoma
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a ) Ciquatera poisonning
Hallmark symptoms of ciguatera include gastrointestinal and neurological effects.[5] Gastrointestinal symptoms include nausea, vomiting, and diarrhea usually followed by neurological symptoms such as headaches, muscle aches, paresthesia, numbness, ataxia, and hallucinations.[2] Severe cases of ciguatera can also result in cold allodynia, which is a burning sensation on contact with cold (commonly incorrectly referred to as reversal of hot/cold temperature sensation
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| neuroblastoma
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 scramboid posining occurs in minutes---- skin flushing, throbbing headache, oral burning, abdominal cramps, nausea, diarrhea, palpitations, a sense of unease, and, rarely prostration or loss of vision. Symptoms usually occur within 10-30 minutes of ingesting the fish
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| hanialkhadher
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a ) Ciquatera poisonning 
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| drdg
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Wow, Good question. I even don't know Ciquatera poisonning. I learnt this today. Thanks.
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| doc_clotaire
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THE ANSWER IS :
B ) SCROMBROID POISONING
a)The symptoms of ciguatera are gastrointestinal distress (nausea, vomiting) followed by neurological symptoms such as headaches, muscle aches, numbness, ataxia, and hallucinations. Severe cases of ciguatera can also result in hot-cold reversal, in which hot and cold sensations seem reversed.Hallmark symptoms of ciguatera include memory loss, muscle weakness, numbness, and extreme fatigue.
g)Infection with the Vibrio para-haemolyticus bacteria is most often associated with ingestion of raw or improperly refrigerated seafood. This illness usually occurs during the warmer months and is most common in the coastal regions of the United States. The primary symptom -- severe, watery, occasionally blood-tinged diarrhea -- generally occurs 12 to 24 hours after eating the contaminated food. The illness rarely lasts more than two days. In severe cases, antibiotics may be useful.
b)Scromboid, or histamine poisoning, is caused by bacterial spoilage of certain finfish, such as tuna, mackerel, bonito, skipjack, mahi-mahi, and bluefish.
Symptoms begin within 2 minutes to 2 hours after eating the fish, and may include rash, diarrhea, flushing of the face, and sweating, headache, dizziness, and vomiting. In addition, individuals may experience burning or swelling of the mouth, abdominal pain, or a metallic taste.
Most people experience mild symptoms which should resolve on their own within 12 hours. Symptoms may be more severe in patients taking certain medications that slow the breakdown of histamine by their liver, such as isoniazide and doxycycline.
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| titly
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so wat is it? scrombroid or ciquatera?
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