Symptomatic Improvement with Amitriptyline in Ciguatera Fish Poisoning

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Abstract
To the Editor: The clinical syndrome associated with ciguatera fish poisoning has been reviewed previously. The dinoflagellate Gambier-discus toxicus is the implicated source of toxicity.1 The symptoms associated with ingestion of the toxin are confined to the gastrointestinal, cardiovascular, and nervous systems.2 The source of ingestion is large fish feeding in tropical reefs.3 Recently, a 52-year-old man was admitted to our institution after a business trip to the Virgin Islands. Two days before departure from the islands, he dined on a locally caught grouper. Within six hours, he had abdominal cramping and watery diarrhea. Lomotil was prescribed and resulted in . . .

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