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INFECTIONS OF LEISURE

INFECTIONS OF LEISURE. At the Shore. (insert picture of a beach). Puffer Fish Poisoning. Rare in U.S., common in Japan which is known as fugu-fugu Tetrodotoxin , heat stable, non-protein Causes total paralysis including respiratory paralysis 60% dies within the first 24 hours.

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INFECTIONS OF LEISURE

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  1. INFECTIONS OF LEISURE

  2. At the Shore • (insert picture of a beach)

  3. Puffer Fish Poisoning • Rare in U.S., common in Japan which is known as fugu-fugu • Tetrodotoxin, heat stable, non-protein • Causes total paralysis including respiratory paralysis • 60% dies within the first 24 hours.

  4. Diagnosis based on clinical history. • Treatment • Remove unabsorbed toxins • Airway support • Volume expansion with IV fluids • Atropine for bradycardia

  5. Ciguatera Food Poisoning • The most commonly reported food borne illness in U.S. • Most common toxins include ciguatoxin and maitotoxin • Lipid soluble • Colorless • Odorless • Heat stable

  6. Incubation period from 2 – 30 hours Symptoms • Filipinos & Chinese are more severely affected, Hawaiians the least • Gastrointestinal • Diarrhea • Nausea & vomiting • Abdominal pain

  7. Symptoms • Neurological • Vertigo • Weakness • Motor paralysis • Blurred vision • Coma • Temperature reversal

  8. Diagnosis on clinical grounds • electrolyte imbalance • Elevated serum ammonia • Treatment is primarily symptomatic • Remove toxin through emesis or gastric lavage with activated charcoal • Intravenous mannitol • Acetamenophen for myalgia

  9. Prevention • Avoid ingesting fish weighing more than 5 pounds • Beware of fish caught during red tides

  10. Scombroid-Fish Poisoning • Definition: • Acute clinical syndrome characterized by histamine toxicity due to ingestion of spoiled fish. • Half of the outbreaks reported to CDC were due fish served in restaurants & cafeterias. BONITO ALBACORE

  11. YELLOW FIN TUNA MACKEREL

  12. Histidinehistamine due to spoilage • Marine bacteria cause spoilage, e.g., M. morganii, K. pneumoniae, E. coli, clostridia, achromobacter, plesiomonas, enterobacter, serratia, & hafnia – common bacteria on fish surface • Histamine is heat stable and freezing stable

  13. Symptoms appear 30 minutes – 4 hours after ingestion of sharp, peppery, & bitter tasting fish. • Flushing & hot sensation of skin • Dizziness & headache • Burning sensation of the mouth & throat • Shortness of breath & palpitations • Skin rash

  14. Diagnosis on clinical grounds • Treatment is supportive and symptomatic • Epinephrine • Oxygen • Corticosteroids • Aminophylline • IV cemetidine

  15. Vibriovulnificus • Found in the pacific and Atlantic coasts • Most invasive and rapidly lethal human pathogen • Major Syndromes • Primary septicemia after ingestion of raw oysters by individuals with liver disease • Most vulnerable are individuals who have liver disease, especially alcoholic cirrhosis

  16. VIBRIO VULNIFICUS • The most invasive and rapidly lethal human pathogen • Septicemia after of raw oysters • Portal of entry is gastrointestinal tract • Incubation period 16 hours • DIC & septic shock • 2nd major syndrome is wound infections • Occurs in first 36 hours on trunk & extremities • Majority of cases from alcohol abuse

  17. Treatment • Prompt institution of ciprofloxacin, combination of ceptazidime & doxycycline

  18. MYCOBACTERIUM MARINUM • Pathogen of salt and freshwater fish • Isolated from swimming pools or aquariums, dead or diseased fish. • Causes cutaneous lesions, osteomyelitis, arthritis, sclero-keratitis

  19. Diagnosis: history & culture • Treatment: minocycline, clarithromycin & doxycycline

  20. Freshwater: Lakes & Hot Tubs • Pseudomonas Dermatitis/Folliculitis • Swimming pools and spas • Synthetic sponges

  21. Swimmer’s ear • Painful & pruritic auditory canal • Recurrent in swimmers • Mild infections respond to 2% acetic acid or eardrops containing topical steroids.

  22. Aeromonas in fish tanks, swimming pools, tap water, and brackish water. • Implicated in gastroenteritis, wounds, & soft tissue infections • Symptoms are fever, pain, edema & foul fish odor • Treatment by broad spectrum cephalosporins, aztreonam & aminoglycosides

  23. Aeromonas in Fish

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