A man was left needing dialysis permanently after eating pufferfish destroyed his kidneys.
The 43-year-old, in Aventura, Florida, went to hospital because he was vomiting, had pain in his stomach, numb legs, difficulty speaking and felt weak.
He admitted he had eaten pufferfish, which is notoriously poisonous, and also taken cocaine within the past three days.
More detailed medical exams showed it was poison from the pufferfish, which is 1,200 times stronger than cyanide, which had made him deathly ill.
His grandmother also fell ill after they shared the meal but she recovered while he, after he ate the liver, which is extra poisonous, was left in intensive care.
Pufferfish is a delicacy called fugu in Japan, but it can only be cooked by highly-qualified chefs because people can die if they eat the livers or ovaries (stock image)
Doctors at the Aventura Hospital and Medical Center, 19 miles from Downtown Miami, revealed the unnamed man’s illness in a case study.
It took just four hours for the man to become seriously ill after he ate the pufferfish.
Medics did not say where he got the ‘uncommon’ fish from but suggested he either bought it on an ‘underground market’ or caught it himself.
In Japan, where the fish is a delicacy called fugu, chefs have to pass strict exams before they are allowed to serve it because people can die if they eat the wrong bit.
The liver – which this man ate – and the ovaries have particularly high levels of the poison called tetrodotoxin, for which there is no antidote, so shouldn’t be eaten.
The Florida patient had extremely high blood pressure when doctors examined him, his speech was garbled and all his limbs were weak.
He also developed pneumonia while he was in hospital and had to be kept in intensive care, where his kidneys failed.
He already had high blood pressure and chronic kidney disease, and the pufferfish poisoning pushed it over the edge and finished off the organs.
At first doctors thought the man’s high blood pressure could have been caused by the cocaine he had taken three days earlier.
And they were then led to believe he had botulism, another type of extreme poisoning which could have been caused by bacteria in food he had eaten.
He was given activated charcoal, an antitoxin, anitibiotics and a drug to help him urinate after he lost the ability to do so naturally.
The medics, led by Dr Patricia Almeida, wrote in the journal BMJ Case Reports: ‘If intoxication does not result in death, symptoms usually recover within 24hours, as was the case with our patient.’
The man regained his muscle strength, his confusion cleared and his pneumonia was healed, but his kidney function never recovered.
He is still dependent on dialysis – in which a machine filters the blood when the kidneys can’t – to this day. His grandmother made a full recovery.
In their case report Dr Almeida and her colleagues recommended people just avoid eating pufferfish altogether.
They said: ‘Pufferfish consumption is not commonly seen in the United States; however, both consumers and healthcare professionals should be aware of its particular life-threatening clinical manifestations’.
And they added that, although the deadly tetrodotoxin is used in tiny quantities in medicines in Japan and China, not enough is known about it.
‘Much remains to be investigated regarding this powerful and paralysing toxin before
it is commercially used,’ they added.
‘For now, we will forewarn the public to refrain from consuming the deadly delicacy known as “fugu”.’