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Critical Care Toxicology pp 1–11Cite as

Ciguatera

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Abstract

Ciguatera poisoning is a multisystem illness caused by the ingestion of fish containing neurotoxins, commonly known as ciguatoxins, though this includes ciguatoxins, maitotoxin, and gambierol, all from the same dinoflagellate source. Ciguatera was known in antiquity, although the term “ciguatera” dates from the seventeenth century Spanish colonization of Cuba [1]. James Cook described an illness producing gastrointestinal (GI) and neurological symptoms typical of ciguatera poisoning while captaining HMS Resolution in 1774 near the Pacific Island of Vanuatu [2]. Although mortality related to ciguatera poisoning is low, symptoms can be disabling and, in a minority of cases, persistent.

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Acknowledgments

The author would like to acknowledge the work of Dr. Fergus Kerr who initially wrote this chapter.

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Authors and Affiliations

  1. Victorian Poisons Information Centre, Heidelberg, VIC, Australia

    Shaun Greene

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  1. Shaun Greene
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Correspondence to Shaun Greene .

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Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Greene, S. (2016). Ciguatera. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_114-1

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