Zimmermann Katharina, Eisenblätter Anneka, Vetter Irina, Ebbecke Martin, Friedemann Miriam, Desel Herbert
Klinik für Anästhesiologie, Universitätsklinikum Erlangen.
Institute for Molecular Biosciences, The University of Queensland.
Dtsch Med Wochenschr. 2015 Jan;140(2):125-30. doi: 10.1055/s-0040-100439. Epub 2015 Jan 22.
Ciguatera is a seafood-borne illness caused by consumption of tropical fish contaminated with ciguatoxins, lipophilic polyethers that are produced in benthic dinoflagellates and accumulate through the marine food chain. Ciguatera cases in Europe usually occur in travellers returning from tropical and subtropical regions of the Pacific and Carribean, where ciguatera is endemic. In 2012, several cases of ciguatera occurred in Germany due to sale of contaminated fish products originating from the Indian Ocean. Although the symptomatology in these cases were typical of ciguatera, with patients reporting gastrointestinal discomfort including nausea, vomiting and diarrhea as well as neurological effects including widespread intense pruritus, paresthesias, hypothermia or altered temperature sensation and diffuse pain, correct diagnosis was delayed in all cases due to lack of awareness of the treating medical practitioners. In light of increasing global mobility, trade, and occurrence of ciguatoxic fish in previously non-endemic areas, ciguatera should be considered as a possible diagnosis if gastrointestinal and neurological symptoms occur shortly after consumption of fish.
雪卡毒素中毒是一种因食用受雪卡毒素污染的热带鱼类而引发的食源性疾病。雪卡毒素是一种亲脂性聚醚，由底栖甲藻产生，通过海洋食物链蓄积。欧洲的雪卡毒素中毒病例通常发生在从太平洋和加勒比地区的热带和亚热带地区返回的旅行者身上，这些地区是雪卡毒素中毒的流行区。2012年，德国发生了几起雪卡毒素中毒病例，原因是销售了来自印度洋的受污染鱼类产品。尽管这些病例的症状是雪卡毒素中毒的典型症状，患者报告有胃肠道不适，包括恶心、呕吐和腹泻，以及神经效应，包括广泛的强烈瘙痒、感觉异常、体温过低或温度感觉改变和弥漫性疼痛，但由于治疗医生缺乏认识，所有病例的正确诊断都被延迟。鉴于全球流动性、贸易的增加以及以前非流行地区出现雪卡毒素中毒鱼类， 如果在食用鱼类后不久出现胃肠道和神经症状，应考虑雪卡毒素中毒为可能的诊断。
