Intoxicación por alimentos, plantas y setas / Poisoning by foodstuffs, plants and mushrooms

La intoxicación alimentaria se define como aquella intoxicación provocada por cualquier alimento o producto alimenticio que por contener sustancias tóxicas, gérmenes, metales, aditivos, hormonas, etc. provocan una intoxicación. Supone una parte muy importante de la Toxicología Clínica, aunque en la mayoría de las estadísticas, las toxiinfecciones alimentarias provocada por bacterias, protozoos y virus no son contabilizadas como intoxicaciones, ya que son provocadas por gérmenes y son recogidas como infecciones. En este tema se hace referencia a todos los tipos de patologías debidas a los alimentos, haciendo hincapié en el botulismo, comentando el cuadro clínico en sus diferentes formas clínicas, pero sobre todo en la forma adulta y contraída mediante el consumo de alimentos mal conservados o poco cocinados; la intoxicación por pescado y por marisco. Se describen también los cuadros toxicológicos a los que puede avocar el consumo de plantas que contienen sustancias tóxicas, encuadradas por las diferentes sintomatologías que producen; por último, se exponen las intoxicaciones por setas según el periodo de incubación y las posibles confusiones (AU)

Tres brotes de ictiosarcotoxicosis por ingestion de Sphyraena barracuda (Walbaum) y Seriola zonata (Mitchill) en el Caribe de Colombia / Three icthyosarcotoxicosis outbreaks due to Sphyraena barracuda (Walbaum) and Seriola dumerili (Mitchill) ingestion on the Colombian Caribbean Coast

Se comentan los tres brotes de ictiosarcotoxicosis (ciguatera) conocidos en las costas colombianas sobre el Mar Caribe, causados por la ingestión de la carne de los peces Sphyraena barracuda (Walbaum) y Seriola dumerili (Mitchill)

The diversity and origins of toxins in ciguatera fish poisoning

The source of the diversity of phytotoxins found in the marine food web is not well understood. It is not clear what roles these secondary metabolites might have in the phytoplankton that produce them. The phytotoxins do not appear to be deterrents of predation, although the production of antibiotics by marine macroalgae might be considered in this light (86). It is equally doubtful that the production and/or presence of these toxins confers a selective advantage on the phytoplankton producers, when in fact the diversity of naturally occurring phytoplankton species may well be maintained by lytic viral infections (22,64). On the other hand, these multiple, diverse toxins may be the products of the different adaptations and interactions that take place between microalgal vectors and the highly variable spectrum of their microbial symbionts. We do not know what selective signals these toxic products may be providing in the maintenance of the symbiont-host consortia in which they are produced, however, their diversity most likely reflects the diversity of symbiotic interactions that exist in these consortia. Woven into the very fabric of the traditional marine food web is an invisible empire of marine micro-organisms, that by its very existence may determine the intense diversity of toxins found in marine biota. Marine bacteria are very likely the most abundant organisms in the sea and to a large degree maintain a food web of their own, often referred to as the microbial loop (64). This microbial web sustains the biogeochemical cycles in the sea. Much of the food produced by phytoplankton and cyanobacteria is consumed by bacteria in the microbial loop and may never enter the food web of larger invertebrates and fishes. Traditionally, the marine food web has been viewed, so to speak, from the top, however, it is now clear that there is an enormous marine microbial food web from which the food web of larger invertebrates and fishes emanates (Figure 13). In many respects the phytotoxins are biomarkers of the interactions between these two food webs. In their very diversity these toxins reflect an amalgam of interacting collaborating forms of life, a complex of phytoplankton hosts and their microbial symbionts producing multiple toxins and their derivatives that ultimately result in the complex medical symptoms they produce in human consumers of poisoned seafoot...

Marea roja: perspectiva histórica / Red tide: historical perspective

En la Marea Roja existen los conceptos de discoloración del agua del mar que generalmente provoca la mortalidad de la fauna marina y el de florecimiento de algas nocivas que causa la toxicidad en los seres humanos. Se presentan: el registro de discoloraciones a nivel mundial muy resumido y el registro de Chile que incluye las primeras descripciones de los investigadores Poepping en 1827 y Darwin en 1835 y que llega hasta 1985. En los florecimientos tóxicos se describen los tipos de toxinas conocidas: ciguatoxina, venerupin shelfish poison; VNM = veneno neurológico de mariscos; VPM = veneno paralizante de mariscos; VDM = veneno diarreico de mariscos y VAM = veneno amnésico de mariscos

Ciguatera fish poisoning: treatment with intravenous mannitol

Intravenous mannitol was given to 16 patients with acute ciguatera fish poisoning requiring hospital admission. Thirteen patients (81 percent) presented with sensory and neuromuscular sympthoms; paraaesthesiae and pain and weaknwss in the lower limbs were predominant features. Mannitol had little effect upon gastrointestinal manifestations, but a marked reduction was observed in the expected duration of neurological symptoms. Although these results are empirical and uncontrolled, they suggest that mannitol infusion may be effective in altering the clinical course of acute ciguatera fish poisoning (AU)

Ciguatoxin-induced food poisoning in a community: implications for disease surveillance and medical practice in Jamaica

This article highlights an outbreak of food poisoning, the result of ingestion of Ciguatoxin-infected fish in a community. The case presentations of the patients involved are used to illustrate the clinical aspects of Ciguatoxin poisoning. The public health aspects of this incident and their relevance to disease surveillance are then discussed. Information of significance to general medical practice in relation to this particular type of fish poisoning, the effect of which could prove fatal in some cases, is also discussed (AU)

Ciguatoxin-induced food poisoning in a community: implications for disease surveillance and medical practice in Jamaica

This article highlights an outbreak of food poisoning, the result of ingestion of Ciguatoxin-infected fish in a community. The case presentations of the patients involved are used to illustrate the clinical aspects of Ciguatoxin poisoning. The public health aspects of this incident and their relevance to disease surveillance are then discussed. Information of significance to general medical practice in relation to this particular type of fish poisoning, the effect of which could prove fatal in some cases, is also discussed

Tratamiento exitoso de cigatera con manitol endovenso

Se trataon 14 pacientes con sintomatología de ciguatera aguda, mediante el uso de Manitol al 20% por vía endovenosa. Todos los pacientes mejoraron en forma dramática la afectación del sistema nervioso y músculo-esquelético en cuestión de minutos; los síntomas gastrointestinales desaparecieron más lentamente; no se presentó ninguna complicación. Aunque el mecanismo de acción del Manitol no está claramente definido, este medicamento debe ser considerado de primera elección en el manejo de los pacientes afectados de ciguatera

Ciguatera toxicity

Ciguatera poisoning is the most common foodborne illness caused by a chemical toxin in the United States and is endemic in the Caribbean and Indo-Pacific. Ciguatoxin, produced by a marine dinoflagellate that attaches to algae, is passed up the food chain to large fish and, finally, to humans. The toxin has anticholinesterase activity. The clinical picture is characterized by a variety of gastrointestinal, neurologic and cardiovascular symptoms, usually self-limited. Amitriptyline is reported to be beneficial.(AU)