Successful treatment of ciguatera fish poisoning with intravenous mannitol
N. A. Palafox, L. G. Jain, A. Z. Pinano, T. M. Gulick, R. K. Williams and I. J. Schatz
Armer Ishoda Memorial Hospital, Majuro, Marshall Islands.
Twenty-four patients with acute ciguatera fish poisoning were treated with
intravenous mannitol, and each patient's condition improved dramatically.
All exhibited marked lessening of neurologic and muscular dysfunction
within minutes of the administration of mannitol. Gastrointestinal symptoms
disappeared more slowly. Two patients in coma and one in shock responded
within minutes, with full recovery after infusion. Although these
observations were empiric and uncontrolled and the mechanism of action of
mannitol in this disease is unclear, mannitol should be considered for
initial use in patients with significant illness and morbidity from
ciguatera fish poisoning.
