Which of the following is the etiologic agent associated with a seafood poisoning that presents with tingling sensations?

• A. Scrombotoxin or ciguatoxin
• B. Tetrodotoxin or saxitoxin
• C. Oyster poisoning
• D. Mullet toxicosis

Answer: (A)

Paresthesias or tingling in the lips, mouth, and face are classic clues for certain seafood poisonings caused by neurotoxic or histamine-like toxins. Scrombotoxin (scombroid) poisoning occurs when fish such as tuna or mackerel are not properly stored, allowing histamine-like substances to form; ciguatoxin poisoning comes from reef fish that have accumulated toxins from dinoflagellates. Both conditions commonly present with tingling sensations, making the combination of scrombotoxin or ciguatoxin the best match for this presentation.

Other options don’t fit as neatly. Tetrodotoxin and saxitoxin can cause tingling, but their hallmark is more pronounced neuromuscular effects like weakness and paralysis. Terms like oyster poisoning or mullet toxicosis aren’t standard etiologies for a tingling-predominant seafood illness, so they’re less appropriate.