Shark poisoning: Consumption of cooked shark meat from large bull and tiger sharks has caused an initial ciguatera-like illness with perioral paresthesias, ataxia, and pruritus, then coma and death (increased CFR = 30%). Structure of two toxins (carchatoxins A and B) is unknown. Mackerel poisoning: Mild, self-limited diarrhea after consumption of cooked mackerel species due to a castor oil-like toxin. Mackerel liver consumption has also caused a hypervitamin-osis-A-like syndrome with headache, nausea, vomiting, diarrhea, and a macular rash that later desquamates. A similar hypervitamin-osis-A-like syndrome occurs after polar bear liver consumption and may cause pseudotumor cerebri.
Mullet poisoning: Mild, self-limited intoxication with delusions, hallucinations, ataxia, and nightmares within minutes to hours after consumption of reef-schooling mullet. Toxin unidentified.
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