Strange medical case of the week:
A young woman came in with vague symptoms- nausea (vomited once), stomach pain, tingling in her hands, numbness in her lips and tongue, and the sensation that when she touched cold water it felt hot like fire. Anyone else with these symptoms? Yes, everyone in the village. Now the story clicked. I had just been talking with the other doctors before clinic and the post-call doc mentioned she had a case of 'barracuda poisoning' come in. My response: "Barracuda poisoning? I've never heard of that before." Other doctor's response: "Oh yeah, ciguatera toxin!" Really?!
Turns out if you eat 'bad fish' (barracuda in this area are especially notorious for it), you can sometimes get this poisoning. Word on the street was that it is in how the fish is prepared and stored, but my internet research reveals it is actually a toxin in dinoflagellates that accumulates in the larger predatory fish....like barracuda. The toxin then causes symptoms in humans, affecting mostly the gastrointestinal system (nausea, vomiting, stomachache) and neurological system (numbness, tingling, confusion, and craziest of all- hot and cold sensation switching like the cold water feeling fiery hot).
So there you have it. We do see some weird tropical diseases here after all.
A young woman came in with vague symptoms- nausea (vomited once), stomach pain, tingling in her hands, numbness in her lips and tongue, and the sensation that when she touched cold water it felt hot like fire. Anyone else with these symptoms? Yes, everyone in the village. Now the story clicked. I had just been talking with the other doctors before clinic and the post-call doc mentioned she had a case of 'barracuda poisoning' come in. My response: "Barracuda poisoning? I've never heard of that before." Other doctor's response: "Oh yeah, ciguatera toxin!" Really?!
Turns out if you eat 'bad fish' (barracuda in this area are especially notorious for it), you can sometimes get this poisoning. Word on the street was that it is in how the fish is prepared and stored, but my internet research reveals it is actually a toxin in dinoflagellates that accumulates in the larger predatory fish....like barracuda. The toxin then causes symptoms in humans, affecting mostly the gastrointestinal system (nausea, vomiting, stomachache) and neurological system (numbness, tingling, confusion, and craziest of all- hot and cold sensation switching like the cold water feeling fiery hot).
So there you have it. We do see some weird tropical diseases here after all.
