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Clinical Stages of Fukuda and Tani for Fugu (Puffer Fish) Poisoning

Description

Fugu poisoning occurs when improperly prepared puffer or porcupine fish is eaten, which results in ingestion of tetrodotoxin. The onset of symptoms occurs briefly afterwards and can progress to death within 24 hours. Fukuda and Tani developed a staging system to describe the clinical signs and symptoms in an affected patient.


Clinical Signs and Symptoms

Stage

Typical Onset After Ingestion

numbness around mouth

perioral parestheseae

with or without GI symptoms such as nausea

1

5 to 45 minutes

numbness of tongue and face

numbness in other areas of skin

early motor paralysis

incoordination and slurred speech

reflexes normal

2

10 to 60 minutes

widespread paralysis

dyspnea and hypotension

aphonia

patient still conscious

pupils may be fixed and dilated

3

15 minutes to several hours

severe muscle paralysis

paralysis of respiratory muscles

hypoxemia and respiratory failure

hypotension

cardiac arrhythmias

bradycardia

patient may be unconscious

4

15 minutes to 24 hours

after Table 3, page 80

 


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