Lobke Snoeks1, Jan Veenstra. 1. Sint Lucas Andreas Ziekenhuis, afd. Interne Geneeskunde, Amsterdam, the Netherlands. l.snoeks@slaz.nl
Abstract
BACKGROUND: Improved aquarium techniques are enabling sea aquariums to imitate reality even better. This means that they sometimes contain known and unknown marine toxins. Aquarium keepers and their families may then develop potentially severe poisoning. CASE DESCRIPTION: A 37-year-old man presented at the Emergency Department with fever, hypotension and symptoms of a metallic taste in the mouth, nausea, headache, shivering and severe muscle cramps. Symptoms appeared after he had tried to remove a colony of Zoanthids (soft corals) from his aquarium by pouring boiling water over them. His wife (35-year-old) and two children (10-year-old twins) had also inhaled the offensive-smelling steam coming from the aquarium and had similar symptoms. On physical examination, all family members had low blood pressure and fever > 38.5 degrees Celsius. Blood analysis showed leucocytosis and an elevated CRP. We diagnosed palytoxin poisoning. All family members recovered within 48 hours after receiving supportive therapy only. CONCLUSION: Manipulation of certain soft corals found in sea aquariums can cause emission of palytoxin. This may cause a potentially severe episode of poisoning. When working in a sea aquarium protective measures should be taken. There is no specific therapy for or antidote to palytoxin poisoning and for this reason, treatment is supportive.
BACKGROUND: Improved aquarium techniques are enabling sea aquariums to imitate reality even better. This means that they sometimes contain known and unknown marine toxins. Aquarium keepers and their families may then develop potentially severe poisoning. CASE DESCRIPTION: A 37-year-old man presented at the Emergency Department with fever, hypotension and symptoms of a metallic taste in the mouth, nausea, headache, shivering and severe muscle cramps. Symptoms appeared after he had tried to remove a colony of Zoanthids (soft corals) from his aquarium by pouring boiling water over them. His wife (35-year-old) and two children (10-year-old twins) had also inhaled the offensive-smelling steam coming from the aquarium and had similar symptoms. On physical examination, all family members had low blood pressure and fever > 38.5 degrees Celsius. Blood analysis showed leucocytosis and an elevated CRP. We diagnosed palytoxinpoisoning. All family members recovered within 48 hours after receiving supportive therapy only. CONCLUSION: Manipulation of certain soft corals found in sea aquariums can cause emission of palytoxin. This may cause a potentially severe episode of poisoning. When working in a sea aquarium protective measures should be taken. There is no specific therapy for or antidote to palytoxinpoisoning and for this reason, treatment is supportive.