Table 1.
Human poisonings due or ascribed to inhalational exposure to vapors or dust from PLTX-contaminated soft corals.
| Location, Year | Number of Patients | Corals | Signs and Symptoms | Treatment and Outcome | PLTXs Detection Method and Concentration | Reference |
|---|---|---|---|---|---|---|
| Virginia (USA), 2007 | 1 | Palythoa/Protopalythoa sp. | Foul odor. Difficult breathing, lightheadedness, chest pain, bronchoconstriction. | Anti-inflammatory corticosteroids and cough suppressant. Recovery after 1 month | Hemolysis neutralization assay (309 µg PLTX eq./g); HPLC (613 µg PLTX eq./g) | [54] |
| The Netherlands, 2014 * | 4 | Palythoa heliodiscus | Cough, dyspnea, chest pain, tachycardia, nausea. Leukocytosis with elevated neutrophils, CPK, CRP | Oxygen therapy, non-steroidal anti-inflammatory drugs. Recovery after more than 3 months | LC/MS (1018 µg PLTX/g wet coral; 46 µg 42-OH-PLTX/g wet coral) | [56] |
| Alaska (USA), 2014 | 3 | Palythoa heliodiscus | Dyspnea, scratchy throat, paresthesia, myalgia, spasms, ataxia, weakness, tremors, nausea, tachycardia, fever | Supportive therapy. Recovery within 2 days | HPLC, LC/MS (7.3 mg PLTX/g wet coral) | [57] |
| Oklahoma (USA), 1961 | 3 | Palythoa caribaeorum | Chills, nausea, headache | Recovery within 1 day | No experimental details (a compound identical to PLTX from P. toxica) | [1] |
| New York (USA), 2008 * | 1 | Palythoa sp. | Foul odor, shortness of breath, chest pain, sinus tachycardia | Inhaled albuterol. Recovery after 48 h | No analysis | [61] |
| The Netherlands, 2012 * | 4 | Zoanthids | Fever, hypotension, nausea, headache, shivering, muscle cramps. Leukocytosis, elevated CRP | Supportive therapy. Recovery within 48 h | No analysis | [62] |
| Switzerland, 2012 * | 3 | Palythoa sp. | Dyspnea, dry cough, nausea, headache, fever, chills, tachycardia, hypoxemia. Leukocytosis, slightly elevated LDH, CRP and procalcitonin. Restrictive ventilator pattern, diffuse bronchial swelling and secretion. | Treatment not reported. Recovery within 2 weeks | No analysis | [63] |
| New York (USA), 2013 * | 5 | Palythoa sp. | Shortness of breath, fever, dry cough, chills, myalgia, emesis. Leukocytosis, slightly elevated LDH, CPK, CKMB | Albuterol, levoflaxic, acetaminophen, hydration and supportive therapy. Recovery within 48 h | No analysis | [64,65] |
| Alaska, (USA), 2012–2014 | 9 | Zoanthids | Bitter metallic taste, fever, tremors, weakness, ataxia, cough, joint and muscle pain, pulmonary symptoms | Treatment not reported. Recovery within 24 h, but sometimes with pulmonary symptoms after 2 years | No analysis | [57] |
| New York (USA), 2015 * | 3 | Zoanthid corals | Fever, chills, myalgia, tachycardia, wheezes, hemoptysis, dyspnea, leukocytosis, bibasilar opacities | Albuterol, acetaminophen, supplemental oxygen, prednisone. Complete recovery after 1 month | No analysis | [66] |
* Year of publication; CPK = creatine phosphokinase; CKMB = creatine kinase MB isoenzyme; CRP = C-reactive protein; LDH = lactate dehydrogenase; eq. = equivalents.