Citation

Almeida P, Diaz R, Hernández F, Ferrer G. BMJ Case Rep. 2019; 12(6): e229272.

Affiliation

Pulmonary Medicine, Aventura Hospital and Medical Center, Aventura, Florida, USA.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bcr-2019-229272

PMID

31177198

Abstract

We report the case of a 43-year-old African American man with a history of hypertension and chronic kidney disease presenting with hypertensive emergency and bulbar paralysis in a descending fashion, which ultimately led to acute respiratory failure. He ingested pufferfish liver during the preceding 4 hours prior to presentation, as well as canned foods and cocaine over the prior 3 days. He had a complicated hospital course requiring intubation and mechanical ventilation, as well as the development of acute respiratory distress syndrome and acute renal failure requiring haemodialysis. This case exemplifies the classic manifestations of tetrodotoxin poisoning with some unique overlapping features, in the setting of an interesting social history.

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

drugs: CNS (not psychiatric); drugs: respiratory system; mechanical ventilation; neuromuscular disease; toxicology