Question - A 32 year old man who works in a pet store presents to the ED with complaints of one week of worsening rhinorrhea with non-productive cough, myalgias, weakness, nausea, paresthesias, ataxia, and tremors. Close questioning reveals the patient’s primary work responsibility involves maintenance of a large number of aquariums in the store. What toxin has likely affected this individual and what is the likely source?
Answer - The likely toxin in the case described above is palytoxin derived from decorative corals used in aquariums. The cited reference notes “Palytoxin (PLTX), one the most potent marine toxins, and/or its analogs, have been identified in different marine organisms, such as Palythoa soft corals, Ostreopsis dinoflagellates, and Trichodesmium cyanobacteria. Although the main concern for human health is PLTXs entrance in the human food chain, there is growing evidence of adverse effects associated with inhalational, cutaneous, and/or ocular exposure to aquarium soft corals contaminated by PLTXs or aquaria waters.” (Pelin M. et al. Palytoxin-containing aquarium soft corals as an emerging sanitary problem. 2016 Mar Drugs 14(2): 33-55)