Spoiled fish have a sharp, peppery taste. Occur in the first hour, and a histamine-like intoxication is seen. There is headache, flushing, dizziness, palpitations and tachycardia. One may see hypotension, bronchospasm, urticaria and anaphylaxis. GI symptoms include nausea, vomiting, diarrhea, abdominal pain, thirst and dysphagia.
Antihistamines appear to be helpful.
Being ingested by pufferfish. The toxin concentrates in the liver and gonads. The toxin inhibits sodium transport, affects neuronal transmission in the CNS and periphery and also affects cardiac nerve conduction and contraction. Consider sedation because cognitive function intact. There will be spontaneous remission if the patient is otherwise supported.