Ciguatera fish poisoning is often associated with gastrointestinal and neurologic complaints. Occasionally genitourinary symptoms may be the chief complaint.
Clinical features:
(1) The patient gives a history of eating fish which is subsequently found to be contaminated with ciguatera toxin.
(2) The patient complains of pain or discomfort during sexual intercourse.
(2a) for males, painful ejaculation
(2b) for females, burning sensation during and after intercourse
(3) The symptoms started after eating the fish.
(4) The symptoms may last several weeks after the fish ingestion then stop.
(5) There is an absence of STD or other explanation.
(6) The symptoms may be accompanied by burning on urination.
The diagnosis can be very difficult if the patient is not in a region where ciguatera fish toxin is common or if a history of fish ingestion is not given.
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