Table 1
Comparative clinical and laboratory characteristics of the three patients poisoned with pufferfish in Van, Turkey
| Parameter | Case 1 (Fatal) | Case 2 (Recovered) | Case 3 (Recovered) |
|---|---|---|---|
| Age/Gender | 41/Male | 31/Male | 41/Male |
| Symptom onset (min) | 90 | 240 | 360 |
| Fish part consumed | Liver (150–200 g) | Muscle (100 g) | Muscle (50 g) |
| Estimated TTX dose* | 2.44 mg | ~0.38 mg | ~0.19 mg |
| Initial symptoms | Perioral numbness, dizziness, vomiting | Perioral numbness, malaise | Perioral numbness, fatigue |
| CTCAE grade | 4 | 2 | 1 |
| Blood pressure (mmHg) | 70/40 | 110/75 | 120/80 |
| Heart rate (bpm) | 105 | 98 | 96 |
| SpO2 (%) | 80 | 94 | 95 |
| pH | 7.179 | 7.38 | 7.40 |
| pCO2 (mmHg) | 63.5 | 38 | 36 |
| Lactate (mmol/L) | 5.3 | 1.2 | 1.1 |
| Mechanical ventilation | Yes | No | No |
| Vasopressor support | Yes (high-dose) | No | No |
| ICU admission | Yes | No | No |
| Hospitalisation (days) | 4 | 1 | 1 |
| Complications | Aspiration pneumonia, cerebral oedema | None | None |
| Outcome | Death (Day 4) | Full recovery | Full recovery |
Figure 1
Pufferfish invasion route from the Suez Canal and likely supply route to the city of Van, Turkey