Patients who present with mild symptoms may be observed and discharged at 8 hours if symptoms have diminished. The incidence of pufferfish poisoning is decreasing, presumably because of heightened awareness and proper preparation of fish. Sardine poisoning Sardine poisoning is rare and episodic. While poorly understood, large numbers of sardines may become toxic at the same time. Anchovies and sprats also may be affected.
Geographic distribution is widespread.
A feeling of anxiety, bizarre behavior, and skin desquamation may occur. Violent GI symptoms precede paresthesias, muscular contractions, and seizures. Marked dysrhythmias and cardiac arrest have been reported. No toxin has been identified, and currently no antidote exists. Treatment is restricted to supportive care.