Florida Man Took Cocaine and Ate Puffer Fish Liver, Ended up in Intensive Care
A Florida man was hospitalized after he and his grandmother ate a potentially lethal puffer fish. The unnamed 43-year-old man visited Aventura Hospital and Medical Center in south Florida, suffering from vomiting and stomach pains.
Both of his legs had gone numb, he felt weak, and he was struggling to speak and stay awake. A pain had erupted in his chest which made it feel as though it was tearing, his doctors wrote in BMJ Case Reports.
Hospital staff learned the man had eaten the liver of a puffer fish four hours before arriving at the hospital. Three days prior, he had also consumed canned food and cocaine.
The patient's grandmother, who had eaten a smaller amount of the fish, also experienced dizziness and weakness in her lower body.
The pair had been poisoned by tetrodotoxin, a potent chemical which is around 1,200 times more toxic to humans than cyanide. There is no known antidote to the poison, which mainly lurks in the liver and ovaries of the fish. Instead, physicians can only offer patients respiratory support until the tetrodotoxin exits the body through urine.
As the man's condition deteriorated, medics put a tube down his throat to protect his airways, and he was admitted to the Intensive Care Unit. The poisoning triggered acute respiratory failure—where the lungs stops oxygenating and removing carbon dioxide from the blood. His blood pressure was dangerously high, and his kidneys stopped working properly.
According to his doctors, the patient also had a history of chronic kidney disease and hypertension.
Eventually, the patient recovered from respiratory failure. But his kidneys did not heal, and he still relies on dialysis.
Puffer fish is considered a delicacy in Japan, where only highly trained and licensed chefs can prepare the dish known as fugu, to protect diners from the potentially deadly consequences.
Intoxication is characterized by tingling lips and tongue, headache, vomiting, muscle weakness, and a loss of coordination. In some cases, patients die because of respiratory and/or heart failure. Symptoms generally show between 30 minutes to six hours after the poison is ingested. In one case in Japan, a man died two hours after eating puffer fish.
The authors of the latest BMJ Case Reports article noted that puffer fish is uncommon in south Florida, but the dangerous food might be available at underground markets.
They also noted this particular case was "exciting" because the man not only consumed puffer fish, but canned food and cocaine "which made the differential diagnoses more broad and interesting."
Mostly, poisonings happen in countries where people know little about the dangers of puffer fish or how to prepare it. In 2008, for instance, 95 people across three districts fell ill after consuming the fish in Bangladesh, the authors wrote. Of those, 14 died. And in 2014, two people in Minneapolis were sickened after buying puffer fish from a street vendor.
The authors concluded: "Much remains to be investigated regarding this powerful and paralysing toxin before it is commercially used. For now, we will forewarn the public to refrain from consuming the deadly delicacy known as 'fugu.'"
