Tetrodotoxin Poisoning Due to Pufferfish Ingestion in the United Arab Emirates

Abstract

Tetrodotoxin is a potent neurotoxin that is found in the ovaries and liver of pufferfish. This lethal toxin is heat stable and does not destroy by cooking that is why precaution should be taken when eating pufferfish. A 60-year-old male presented to the ED after eating pufferfish complaining of perioral and hand numbness, gait disturbance, and generalized body weakness. This presentation is due to a tetrodotoxin found in and not limited to the pufferfish he ingested. Despite having pufferfish with his family, he was the sole person to have symptoms because, unlike the other family members, he ate from the liver part of the fish. The patient was admitted for observation, received supportive care, and underwent multiple investigations that most came to be normal. He improved gradually and was discharged after staying for three nights in the hospital. Symptoms after eating the toxic parts of a pufferfish may progress to paralysis, and respiratory failure, and may lead to death. It is not common to have such fish eaten in the United Arab Emirates due to its limited availability.