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Selene vomer
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Class: Actinopterygii (ray-finned fishes)
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Order: Perciformes
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Family: Carangidae
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Genus: Selene
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Species: vomer
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Common Names
Wireback, Moonshine, Moonfish, Lookdown, Jack, Horsehead, Hairfinned silverfish, Hairfinned dory, Flatjack, Dollarfish
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Taxonomy and Biology
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No information available for Taxonomy and Biology
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Poison
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General: Neurotoxins
Ingestion of ciguatoxin can cause excitatory neurotoxic effects
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General: Myotoxins
Does not occur, based on current clinical evidence
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General: Procoagulants
Not present
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General: Anticoagulants
Not present
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General: Haemorrhagins
Not present
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General: Nephrotoxins
Not present
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General: Cardiotoxins
Not present
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General: Necrotoxins
Not present
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General: Other Toxins
Unknown
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Clinical Effects
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General: Dangerousness
Severe poisoning possible, potentially but rarely lethal
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General: Rate of Envenoming: Not applicable
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General: Untreated Lethality Rate: Unknown but lethal potential cannot be excluded
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General: Local Effects
Not applicable
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General: Local Necrosis
Not applicable
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General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, tachypnoea, respiratory distress, hypotension, dizziness, collapse or convulsions
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General: Neurotoxic Paralysis
Nervous system effects are a key feature and include parasthesiae, hot-cold reversal, but not classic flaccid paralysis.
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General: Myotoxicity
Does not occur, based on current clinical evidence
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General: Renal Damage
Does not occur, based on current clinical evidence
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General: Cardiotoxicity
May cause tachy-or bradycardia, hypo- or hypertension.
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General: Other
Nil specific
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First Aid
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Description: First aid for Ciguatera poisoning
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Details
1. If still within 1-3 hours after the fish meal, and providing the patient has absolutely no symptoms suggesting any degree of paralysis or difficulty swallowing or has drooling of saliva, then induce vomiting, if practical, to remove undigested fish from the stomach.
2. Seek medical attention.
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Treatment
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Treatment Summary
Treatment requires a two pronged approach. The gastrointestinal symptoms may be severe, requiring rehydration with IV fluids and antiemetics and anti-diarrhoeals. The neurological symptoms respond to IV mannitol 20% (1g/kg IV over 30 minutes), though effectiveness is inversely proportional to the length of delay in commencing treatment. Initial improvement, followed by recurrence should be treated with further mannitol. A number of pharmaceuticals have been tried to remedy various ciguatera symptoms and reports of effectiveness are often conflicting. However, doxepin, antihistamines and fluoxetine have all showed benefits.
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Key Diagnostic Features
The clinical syndrome of ciguatera poisoning is characterized by initial features of standard food poisoning, with nausea, vomiting, diarrhoea and abdominal pain, but with distinctive neurological features, including myalgia, burning feeling of the skin on contact with cold water, pruritis, arthralgia, parasthesia (especially hands, feet, mouth), headache, altered or labile mood, ataxia and vertigo, increased sweating, ocular pain, painful teeth, tremors, neck stiffness, reduced muscle power, increased salivation and general malaise.
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General Approach to Management
All cases should be fully assessed, rehydrated if there has been GIT fluid loss (vomiting & diarrhoea), IV mannitol considered, then symptomatic treatment.
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Antivenom Therapy
Not applicable
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Images
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No images for Images
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