A Salt-Water Aquarium can be a Dangerous Hobby:A Case Report of Palytoxin Intoxication after Dermal Contact with Poisonous Coral

Abstract

Palythoa toxica is a coral that is often sold to aquarium holders. It contains one of the most toxic substances known to human: palytoxin. It is important for clinicians to recognize this potential lethal intoxication. A 39 year old man presented to the Emergency Department (ED) complaining of rigors, dyspnea, dizziness, atypical chest pain, tremor, and dysarthria. Medical history taking revealed that he was a professional coral dealer. He recalled accidental dermal exposure to mucus of Palythoa toxica four hours before symptoms started. His laboratory tests showed signs of muscular and cardiac damage. He was admitted to the hospital and had a full recovery. Intoxications with palytoxin are potentially lethal. Since the Palythoa coral is often sold to new aquarium holders there is probably an underreporting of cases as many patients and doctors would not link the symptoms to coral exposure. In the setting of an emergency department, physicians should be aware of the symptoms of palytoxin intoxication, including patients with rhabdomyolysis, and ask patients with relevant symptoms about potential contact with corals.