Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
Singapore Med J. 2013 Jun;54(6):e120-2. doi: 10.11622/smedj.2013095.
Ciguatera results when ciguatoxin-contaminated coral reef fish from tropical or subtropical waters are consumed. The clinical features that present in affected persons are mainly gastrointestinal, neurological, general, and much less commonly, cardiovascular. We report the case of a 50-year-old man who developed the characteristic combination of acute gastrointestinal and neurological symptoms after the consumption of an unidentified coral reef fish head. In addition to those symptoms, he developed dizziness, severe bradycardia (46 bpm) and prolonged hypotension, which required the administration of intravenous atropine and over three days of intravenous fluid replacement with dopamine infusion. Patients with ciguatera can develop severe bradycardia and prolonged hypotension. Physicians should recognise the possible cardiovascular complications of ciguatera and promptly initiate treatment with intravenous atropine, intravenous fluid replacement and inotropic therapy if such complications are observed.
雪卡毒素中毒是由进食受热带或亚热带海域雪卡毒素污染的珊瑚礁鱼类引起。受影响者的临床表现主要为胃肠道、神经、全身，较少见的还有心血管。我们报告了 1 例 50 岁男性，在食用了 1 个不明珊瑚礁鱼头后出现典型的急性胃肠道和神经系统症状。除了这些症状，他还出现头晕、严重心动过缓（46 次/分）和长时间低血压，需要静脉注射阿托品，并静脉补液 3 天，同时给予多巴胺输注。雪卡毒素中毒患者可能出现严重心动过缓和长时间低血压。医生应认识到雪卡毒素中毒可能出现心血管并发症，如果观察到这些并发症，应立即开始使用静脉注射阿托品、静脉补液和正性肌力治疗。
