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Article
May 13, 1988

Successful Treatment of Ciguatera Fish Poisoning With Intravenous Mannitol

Author Affiliations

From the Armer Ishoda Memorial Hospital, Majuro, Marshall Islands (Drs Palafox, Jain, Pinano, Gulick, and Williams); and the Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu (Drs Palafox, Gulick, and Schatz). Drs Palafox and Williams are employees of the Public Health Service assigned through the National Health Service Corps to the Department of Health of the Republic of the Marshall Islands.

From the Armer Ishoda Memorial Hospital, Majuro, Marshall Islands (Drs Palafox, Jain, Pinano, Gulick, and Williams); and the Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu (Drs Palafox, Gulick, and Schatz). Drs Palafox and Williams are employees of the Public Health Service assigned through the National Health Service Corps to the Department of Health of the Republic of the Marshall Islands.

JAMA. 1988;259(18):2740-2742. doi:10.1001/jama.1988.03720180066035
Abstract

Twenty-four patients with acute ciguatera fish poisoning were treated with intravenous mannitol, and each patient's condition improved dramatically. All exhibited marked lessening of neurologic and muscular dysfunction within minutes of the administration of mannitol. Gastrointestinal symptoms disappeared more slowly. Two patients in coma and one in shock responded within minutes, with full recovery after infusion. Although these observations were empiric and uncontrolled and the mechanism of action of mannitol in this disease is unclear, mannitol should be considered for initial use in patients with significant illness and morbidity from ciguatera fish poisoning.

(JAMA 1988;259:2740-2742)

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