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Fatal pufferfish poisoning 1000 km inland: a case series from eastern Turkey Cover

Fatal pufferfish poisoning 1000 km inland: a case series from eastern Turkey

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Open Access
|Jun 2026

Figures & Tables

Figure 1

Pufferfish invasion route from the Suez Canal and likely supply route to the city of Van, Turkey

Comparative clinical and laboratory characteristics of the three patients poisoned with pufferfish in Van, Turkey

ParameterCase 1 (Fatal)Case 2 (Recovered)Case 3 (Recovered)
Age/Gender41/Male31/Male41/Male
Symptom onset (min)90240360
Fish part consumedLiver (150–200 g)Muscle (100 g)Muscle (50 g)
Estimated TTX dose*2.44 mg~0.38 mg~0.19 mg
Initial symptomsPerioral numbness, dizziness, vomitingPerioral numbness, malaisePerioral numbness, fatigue
CTCAE grade421
Blood pressure (mmHg)70/40110/75120/80
Heart rate (bpm)1059896
SpO2 (%)809495
pH7.1797.387.40
pCO2 (mmHg)63.53836
Lactate (mmol/L)5.31.21.1
Mechanical ventilationYesNoNo
Vasopressor supportYes (high-dose)NoNo
ICU admissionYesNoNo
Hospitalisation (days)411
ComplicationsAspiration pneumonia, cerebral oedemaNoneNone
OutcomeDeath (Day 4)Full recoveryFull recovery
DOI: https://doi.org/10.2478/aiht-2026-77-4088 | Journal eISSN: 1848-6312 | Journal ISSN: 0004-1254
Language: English
Page range: 149 - 152
Submitted on: Dec 1, 2025
Accepted on: May 1, 2026
Published on: Jun 30, 2026
In partnership with: Paradigm Publishing Services

© 2026 Mehmet Tatlı, Selin Bulut, published by Institute for Medical Research and Occupational Health
This work is licensed under the Creative Commons Attribution 4.0 License.