A fatal case of severe pufferfish poisoning

Abstract

Abstract Introduction: Pufferfish poisoning is the main cause of death due to food poisoning in China. No effective treatment has been proposed so far. The artificial airway and early mechanical ventilation are crucial for the prognosis, but the optimal time for these interventions remains unclear. Here we present an unsuccessful use of mechanical respiratory support in a patient with pufferfish poisoning. Patient concerns: A 62-year-old male patient presented to the emergency department with complaints of numbness around the mouth. He gave a history of eating pufferfish 3 hours before the coming to the hospital. Diagnosis: He was diagnosed as pufferfish poisoning based on the history of consuming pufferfish and the symptom of numbness. Interventions: Gastric lavage was performed in time, but he did not receive protective endotracheal intubation. His condition worsened rapidly with respiratory failure and cardiac arrest. He received active treatment in the intensive care unit with mechanical ventilation. Outcomes: Spontaneous breathing was not restored during the intensive care unit stay. He underwent treatment with hyperbaric oxygen in another hospital and died of respiratory failure eventually. Conclusion: The establishment of artificial airway and early implementation of mechanical ventilation are crucial for good prognosis. Our case report provides a valuable experience for implementing early endotracheal intubation intervention in patients with pufferfish poisoning.