Funtabulously Frivolous Friday Five 083

• Because he/she could get ciguatera poisoning (Queensland pdf factsheet).
• A chinaman is a species of piscivorous reef fish. It is notorious for being contaminated by ciguatera toxin. The toxin is produced by microalgae, ingested by smaller fish, passed up the foodchain, and concentrated in the heads and viscera of larger fish like the chinaman. Ingestion of contaminated fish by humans produces vomiting, paraesthesia, and the bizarre phenomenon of cold allodynia.
• Ciguatera is much less common in the waters off WA.

• In the hepatic abscess of a patient with cystic hydatid disease.
• Cystic hydatid disease is a worldwide, potentially devastating zoonosis caused by Echinococcus granolosus. The pastoral life cycle involves sheepdogs (definitive host) and sheep (intermediate host). Humans get involved if they accidentally ingest sheepdog faeces containing tapeworm eggs: the onchospheres hatch in the gut, migrate to the liver and form large abscesses. The pus is tainted by altered blood and is said to resemble anchovy sauce.
• Anchovy sauce pus is also a topping on a “Lesion-Lovers” Pathology Specimen Pizza.

From the Oxford Textbook of Medicine - click image for source

See comment from Anandan below.

• It isn’t – or rather it shouldn’t be.
• The existence of immunological cross-reactivity between shellfish, tincture of iodine, and iodinated contrast media is a medical myth. The most common precipitant of shellfish allergy is molluscan tropomyosin. Povidone-iodine (Betadine) and iodinated contrast media are unrelated compounds. While some caution should be exercised in giving contrast media to people with a history of anaphylaxis, those with seafood allergies are at no greater risk than those with allergies to fruit or nuts.

Schabelman E, Witting M. The relationship of radiocontrast, iodine, and seafood allergies: a medical myth exposed. J Emerg Med. 2010 Nov;39(5):701-7. Epub 2010 Jan 4. Review. PMID: 20045605

• Protamine sulphate and NPH insulin.
• Protamine is a poly-cation that helps pack DNA into the heads of sperm. It also forms electrostatic bonds with insulin, delaying its systemic release; and heparin, reversing therapeutic anticoagulation.
• There is a worldwide shortage of protamine, after recent legislation removed anonymity for donor salmon.

• By excluding marine fish from the diet.
• Trimethylaminuria is a rare autosomal recessive condition caused by a hepatic enzyme deficiency. This leads to a build-up of trimethylamine (TMA) in sweat, urine and breath, producing a strong fishy body odour. Sadly the condition manifests in adolescence and there is no cure. Sufferers are advised to avoid eating fish, eggs and soybeans, as they contain precursors to TMA.
• Shakespeare’s Caliban, a savage and deformed island dweller, may have had fish odour syndrome:

“What have we here? A man or a fish? Dead or alive? A fish: he smells like a fish; a very ancient and fish-like smell”

— Trinculo the Jester, The Tempest II. ii. 26-29