Palytoxin Poisoning After Dermal Contact with Zoanthid Coral
Abstract Background: Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity from zoanthid coral in a patient with intact skin. Case Report: A 25-year-old previously healthy woman handled a zoanthid coral from...
Saved in:
Published in | The Journal of emergency medicine Vol. 40; no. 4; pp. 397 - 399 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.04.2011
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Abstract Background: Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity from zoanthid coral in a patient with intact skin. Case Report: A 25-year-old previously healthy woman handled a zoanthid coral from a home aquarium without any barrier protection. The patient manifested neurologic symptoms of perioral paresthesia and dysguesia. In addition, there was local dermatologic toxicity that persisted for several days. The patient was treated supportively with corticosteroids and a histamine antagonist. Conclusion: We report a case of palytoxin poisoning from dermal absorption after handling a zoanthid coral. Palytoxin is a potent marine toxin that affects the sodium-potassium ATPase (adenosinetriphosphatase) pump and can cause multiple clinical effects, including paresthesia, dysguesia, hypertension, respiratory depression, coma, and death. |
---|---|
AbstractList | Abstract Background: Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity from zoanthid coral in a patient with intact skin. Case Report: A 25-year-old previously healthy woman handled a zoanthid coral from a home aquarium without any barrier protection. The patient manifested neurologic symptoms of perioral paresthesia and dysguesia. In addition, there was local dermatologic toxicity that persisted for several days. The patient was treated supportively with corticosteroids and a histamine antagonist. Conclusion: We report a case of palytoxin poisoning from dermal absorption after handling a zoanthid coral. Palytoxin is a potent marine toxin that affects the sodium-potassium ATPase (adenosinetriphosphatase) pump and can cause multiple clinical effects, including paresthesia, dysguesia, hypertension, respiratory depression, coma, and death. Background: Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity from zoanthid coral in a patient with intact skin. Case Report: A 25-year-old previously healthy woman handled a zoanthid coral from a home aquarium without any barrier protection. The patient manifested neurologic symptoms of perioral paresthesia and dysguesia. In addition, there was local dermatologic toxicity that persisted for several days. The patient was treated supportively with corticosteroids and a histamine antagonist. Conclusion: We report a case of palytoxin poisoning from dermal absorption after handling a zoanthid coral. Palytoxin is a potent marine toxin that affects the sodium-potassium ATPase (adenosinetriphosphatase) pump and can cause multiple clinical effects, including paresthesia, dysguesia, hypertension, respiratory depression, coma, and death. Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity from zoanthid coral in a patient with intact skin. A 25-year-old previously healthy woman handled a zoanthid coral from a home aquarium without any barrier protection. The patient manifested neurologic symptoms of perioral paresthesia and dysguesia. In addition, there was local dermatologic toxicity that persisted for several days. The patient was treated supportively with corticosteroids and a histamine antagonist. We report a case of palytoxin poisoning from dermal absorption after handling a zoanthid coral. Palytoxin is a potent marine toxin that affects the sodium-potassium ATPase (adenosinetriphosphatase) pump and can cause multiple clinical effects, including paresthesia, dysguesia, hypertension, respiratory depression, coma, and death. |
Author | Zahller, Stephen, MD Clark, Richard F., MD Cantrell, F. Lee, MD Nordt, Sean Patrick, MD, PHARMD Wu, Jerry, BS |
Author_xml | – sequence: 1 fullname: Nordt, Sean Patrick, MD, PHARMD – sequence: 2 fullname: Wu, Jerry, BS – sequence: 3 fullname: Zahller, Stephen, MD – sequence: 4 fullname: Clark, Richard F., MD – sequence: 5 fullname: Cantrell, F. Lee, MD |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/19545971$$D View this record in MEDLINE/PubMed |
BookMark | eNqFkU9v1DAQxS1URLeFr1DlyCVh7MR2LCFEtfyVKlEJuHCxHGdCHbJ2sb3Afnsc7cKBC6eRZt57o_nNBTnzwSMhVxQaClQ8m5sZdxh3ODYMQDXAG4DuAdmwlrOaA1NnZAOyFXUnpDonFynNAFRCTx-Rc6p4x5WkG_L81iyHHH45X90Gl4J3_mt1PWWM1asSb5ZqG3w2Nlc_Xb6rvgTj850bSzea5TF5OJkl4ZNTvSSf37z-tH1X33x4-357fVPbjvNcd3YC03IBArkwQ8-44gOfpIQRWqm6Saheqn4yrcDeTor1I3DW92xg4zAa0V6Sp8fc-xi-7zFlvXPJ4rIYj2GfNC3hinWyl0UqjlIbQ0oRJ30f3c7Eg6agV3J61n_I6ZWcBq4LuWK8Ou3YD-vsr-2EqgheHgVYLv3hMOpkHXqLo4tosx6D-_-OF_9E2MV5Z83yDQ-Y5rCPvnDUVCemQX9c_7e-DxRA23LZ_gZfZpgS |
CitedBy_id | crossref_primary_10_1002_med_21476 crossref_primary_10_1016_j_lpm_2017_11_004 crossref_primary_10_1016_j_gfs_2017_03_002 crossref_primary_10_1007_s11596_015_1506_3 crossref_primary_10_1016_j_toxicon_2016_08_012 crossref_primary_10_1016_j_toxicon_2019_06_020 crossref_primary_10_1039_C6TX00084C crossref_primary_10_3390_md14020033 crossref_primary_10_3390_toxins10080324 crossref_primary_10_1080_24734306_2018_1480994 crossref_primary_10_3109_15563650_2015_1016165 crossref_primary_10_1007_s13341_017_0708_6 crossref_primary_10_1007_s13127_022_00550_2 crossref_primary_10_3390_md20030198 crossref_primary_10_1021_acs_analchem_7b01003 crossref_primary_10_1016_j_etap_2017_08_010 crossref_primary_10_1136_vr_105686 crossref_primary_10_2478_aiht_2019_70_3209 crossref_primary_10_1155_2015_621815 crossref_primary_10_1016_j_toxac_2018_11_003 crossref_primary_10_1007_s00204_017_2105_8 crossref_primary_10_1016_j_toxlet_2014_07_022 crossref_primary_10_2147_OPTH_S290455 crossref_primary_10_1016_j_toxicon_2015_09_001 |
Cites_doi | 10.1016/S0041-0101(98)00133-0 10.1016/j.toxicon.2008.03.009 10.2169/internalmedicine.47.0847 10.1002/jnr.21095 10.2169/internalmedicine.37.330 10.3390/md6020349 10.1016/0041-0101(88)90142-0 10.1159/000233075 10.1016/0306-3623(94)00133-8 |
ContentType | Journal Article |
Copyright | Elsevier Inc. 2011 Elsevier Inc. Copyright © 2011 Elsevier Inc. All rights reserved. |
Copyright_xml | – notice: Elsevier Inc. – notice: 2011 Elsevier Inc. – notice: Copyright © 2011 Elsevier Inc. All rights reserved. |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 7TN 7U7 C1K F1W H95 L.G |
DOI | 10.1016/j.jemermed.2009.05.004 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef Oceanic Abstracts Toxicology Abstracts Environmental Sciences and Pollution Management ASFA: Aquatic Sciences and Fisheries Abstracts Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources Aquatic Science & Fisheries Abstracts (ASFA) Professional |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef Aquatic Science & Fisheries Abstracts (ASFA) Professional Oceanic Abstracts Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources Toxicology Abstracts ASFA: Aquatic Sciences and Fisheries Abstracts Environmental Sciences and Pollution Management |
DatabaseTitleList | Aquatic Science & Fisheries Abstracts (ASFA) Professional MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 2352-5029 |
EndPage | 399 |
ExternalDocumentID | 10_1016_j_jemermed_2009_05_004 19545971 S0736467909003357 1_s2_0_S0736467909003357 |
Genre | Research Support, U.S. Gov't, Non-P.H.S Journal Article Case Reports |
GroupedDBID | --- --K --M .1- .FO .GJ .~1 0R~ 1B1 1CY 1P~ 1RT 1~. 1~5 29K 4.4 457 4G. 53G 5GY 5RE 5VS 7-5 71M 8P~ 9JM AACTN AAEDT AAEDW AAIKJ AAKOC AALRI AAOAW AAQFI AAQOH AAQQT AAQXK AAWTL AAXKI AAXUO AAYOK ABBQC ABFNM ABJNI ABMAC ABMZM ABXDB ACDAQ ACGFS ACIUM ACRLP ADBBV ADEZE ADMUD AEBSH AEKER AENEX AEVXI AFCTW AFJKZ AFKWA AFRHN AFTJW AFXIZ AGHFR AGUBO AGYEJ AHHHB AIEXJ AIKHN AITUG AJOXV AJRQY AJUYK AKRWK ALMA_UNASSIGNED_HOLDINGS AMFUW AMRAJ ANZVX ASPBG AVWKF AXJTR AZFZN BKOJK BLXMC BNPGV CS3 D-I DU5 EBS EFJIC EJD EO8 EO9 EP2 EP3 EX3 F5P FDB FEDTE FGOYB FIRID FNPLU FYGXN G-2 G-Q GBLVA HDV HMK HMO HVGLF HZ~ IHE J1W K-O KOM L7B LX1 M29 M41 MO0 N9A O-L O9- OAUVE OB~ OM0 OZT P-8 P-9 P2P PC. Q38 R2- RIG ROL RPZ SAE SCC SDF SDG SDP SEL SES SEW SPCBC SSH SSZ T5K UHS UKR UV1 WOW WUQ XPP Z5R ZGI ~G- AAIAV ABLVK ABYKQ AJBFU EFLBG LCYCR ZA5 CGR CUY CVF ECM EIF NPM AAYXX CITATION 7TN 7U7 C1K F1W H95 L.G |
ID | FETCH-LOGICAL-c455t-4cf0a35606e56ab82595b5f770d03794f698798fa36e8cf928d052882b2dbda63 |
IEDL.DBID | AIKHN |
ISSN | 0736-4679 |
IngestDate | Fri Aug 16 10:26:44 EDT 2024 Thu Sep 26 18:33:52 EDT 2024 Sat Sep 28 07:55:35 EDT 2024 Fri Feb 23 02:26:50 EST 2024 Tue Oct 15 22:56:18 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 4 |
Keywords | palytoxin zoanthid coral |
Language | English |
License | Copyright © 2011 Elsevier Inc. All rights reserved. |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c455t-4cf0a35606e56ab82595b5f770d03794f698798fa36e8cf928d052882b2dbda63 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
PMID | 19545971 |
PQID | 1356924787 |
PQPubID | 23462 |
PageCount | 3 |
ParticipantIDs | proquest_miscellaneous_1356924787 crossref_primary_10_1016_j_jemermed_2009_05_004 pubmed_primary_19545971 elsevier_sciencedirect_doi_10_1016_j_jemermed_2009_05_004 elsevier_clinicalkeyesjournals_1_s2_0_S0736467909003357 |
PublicationCentury | 2000 |
PublicationDate | 2011-04-01 |
PublicationDateYYYYMMDD | 2011-04-01 |
PublicationDate_xml | – month: 04 year: 2011 text: 2011-04-01 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | The Journal of emergency medicine |
PublicationTitleAlternate | J Emerg Med |
PublicationYear | 2011 |
Publisher | Elsevier Inc |
Publisher_xml | – name: Elsevier Inc |
References | Okano, Masuoka, Kamei (bib3) 1998; 37 Onuma, Satake, Ukena (bib5) 1999; 37 Frelin, Van Renterghem (bib12) 1995; 26 Alcala, Alcala, Garth (bib6) 1988; 26 Hoffmann, Hermanns-Clausen, Buhl (bib1) 2008; 51 bib10 bib11 Majilesi, Su, Chan (bib8) 2008; 46 Shinzato, Furus, Nishino (bib7) 2008; 47 Kitamura, Taguchi, Yokoyama (bib9) 1983; 14 Wang (bib4) 2008; 6 Vale-Gonzalez, Gomez-Limia, Vieytes, Botana (bib2) 2007; 85 Chhatwal, Ahnert-Hilger, Beress, Habermann (bib13) 1982; 68 Alcala (10.1016/j.jemermed.2009.05.004_bib6) 1988; 26 Wang (10.1016/j.jemermed.2009.05.004_bib4) 2008; 6 Majilesi (10.1016/j.jemermed.2009.05.004_bib8) 2008; 46 Vale-Gonzalez (10.1016/j.jemermed.2009.05.004_bib2) 2007; 85 Okano (10.1016/j.jemermed.2009.05.004_bib3) 1998; 37 Chhatwal (10.1016/j.jemermed.2009.05.004_bib13) 1982; 68 Kitamura (10.1016/j.jemermed.2009.05.004_bib9) 1983; 14 Shinzato (10.1016/j.jemermed.2009.05.004_bib7) 2008; 47 Frelin (10.1016/j.jemermed.2009.05.004_bib12) 1995; 26 Hoffmann (10.1016/j.jemermed.2009.05.004_bib1) 2008; 51 Onuma (10.1016/j.jemermed.2009.05.004_bib5) 1999; 37 |
References_xml | – volume: 26 start-page: 105 year: 1988 end-page: 107 ident: bib6 article-title: Human fatality due ingestion of the crab publication-title: Toxicon contributor: fullname: Garth – volume: 68 start-page: 97 year: 1982 end-page: 100 ident: bib13 article-title: Palytoxin both induces and inhibits the release of histamine from rat mast cells publication-title: Int Arch Allergy Appl Immunol contributor: fullname: Habermann – volume: 6 start-page: 349 year: 2008 end-page: 371 ident: bib4 article-title: Neurotoxins from marine dinoflagellates: a brief review publication-title: Mar Drugs contributor: fullname: Wang – volume: 37 start-page: 330 year: 1998 end-page: 333 ident: bib3 article-title: Rhabdomyolysis and myocardial damage induced by palytoxin, a toxin of blue humphead parrotfish publication-title: Intern Med contributor: fullname: Kamei – volume: 85 start-page: 90 year: 2007 end-page: 98 ident: bib2 article-title: Effects of the marine phycotoxin palytoxin on neuronal pH in primary cultures of cerebellar granule cells publication-title: J Neurosci Res contributor: fullname: Botana – ident: bib10 article-title: ReefPedia: the Reef Aquarium Encycopedia – volume: 26 start-page: 33 year: 1995 end-page: 37 ident: bib12 article-title: Palytoxin publication-title: Gen Pharmacol contributor: fullname: Van Renterghem – volume: 47 start-page: 853 year: 2008 end-page: 856 ident: bib7 article-title: Cowfish ( publication-title: Intern Med contributor: fullname: Nishino – volume: 37 start-page: 55 year: 1999 end-page: 65 ident: bib5 article-title: Identification of putative palytoxin as cause of clupeotoxism publication-title: Toxicon contributor: fullname: Ukena – volume: 46 start-page: 637 year: 2008 ident: bib8 article-title: A case of inhalational exposure to palytoxin (abstract) publication-title: Clin Toxicol contributor: fullname: Chan – volume: 14 start-page: 327 year: 1983 end-page: 334 ident: bib9 article-title: Increase in histidine decarboxylase activity in mouse skin after application of tumor promoters publication-title: Princess Takamatsu Symp contributor: fullname: Yokoyama – volume: 51 start-page: 1535 year: 2008 end-page: 1537 ident: bib1 article-title: A case of palytoxin poisoning due to contact with zoanthid corals through a skin injury publication-title: Toxicon contributor: fullname: Buhl – ident: bib11 article-title: Material Safety Data Sheet: Palytoxin – volume: 37 start-page: 55 year: 1999 ident: 10.1016/j.jemermed.2009.05.004_bib5 article-title: Identification of putative palytoxin as cause of clupeotoxism publication-title: Toxicon doi: 10.1016/S0041-0101(98)00133-0 contributor: fullname: Onuma – volume: 51 start-page: 1535 year: 2008 ident: 10.1016/j.jemermed.2009.05.004_bib1 article-title: A case of palytoxin poisoning due to contact with zoanthid corals through a skin injury publication-title: Toxicon doi: 10.1016/j.toxicon.2008.03.009 contributor: fullname: Hoffmann – volume: 47 start-page: 853 year: 2008 ident: 10.1016/j.jemermed.2009.05.004_bib7 article-title: Cowfish (Umisuzume, Lactoria diaphana) poisoning with rhabdomyolysis publication-title: Intern Med doi: 10.2169/internalmedicine.47.0847 contributor: fullname: Shinzato – volume: 14 start-page: 327 year: 1983 ident: 10.1016/j.jemermed.2009.05.004_bib9 article-title: Increase in histidine decarboxylase activity in mouse skin after application of tumor promoters publication-title: Princess Takamatsu Symp contributor: fullname: Kitamura – volume: 46 start-page: 637 year: 2008 ident: 10.1016/j.jemermed.2009.05.004_bib8 article-title: A case of inhalational exposure to palytoxin (abstract) publication-title: Clin Toxicol contributor: fullname: Majilesi – volume: 85 start-page: 90 year: 2007 ident: 10.1016/j.jemermed.2009.05.004_bib2 article-title: Effects of the marine phycotoxin palytoxin on neuronal pH in primary cultures of cerebellar granule cells publication-title: J Neurosci Res doi: 10.1002/jnr.21095 contributor: fullname: Vale-Gonzalez – volume: 37 start-page: 330 year: 1998 ident: 10.1016/j.jemermed.2009.05.004_bib3 article-title: Rhabdomyolysis and myocardial damage induced by palytoxin, a toxin of blue humphead parrotfish publication-title: Intern Med doi: 10.2169/internalmedicine.37.330 contributor: fullname: Okano – volume: 6 start-page: 349 year: 2008 ident: 10.1016/j.jemermed.2009.05.004_bib4 article-title: Neurotoxins from marine dinoflagellates: a brief review publication-title: Mar Drugs doi: 10.3390/md6020349 contributor: fullname: Wang – volume: 26 start-page: 105 year: 1988 ident: 10.1016/j.jemermed.2009.05.004_bib6 article-title: Human fatality due ingestion of the crab Demenia reyanudii that contained a palytoin-like toxin publication-title: Toxicon doi: 10.1016/0041-0101(88)90142-0 contributor: fullname: Alcala – volume: 68 start-page: 97 year: 1982 ident: 10.1016/j.jemermed.2009.05.004_bib13 article-title: Palytoxin both induces and inhibits the release of histamine from rat mast cells publication-title: Int Arch Allergy Appl Immunol doi: 10.1159/000233075 contributor: fullname: Chhatwal – volume: 26 start-page: 33 year: 1995 ident: 10.1016/j.jemermed.2009.05.004_bib12 article-title: Palytoxin publication-title: Gen Pharmacol doi: 10.1016/0306-3623(94)00133-8 contributor: fullname: Frelin |
SSID | ssj0017081 |
Score | 2.1772003 |
Snippet | Abstract Background: Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local... Background: Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity... Palytoxin is most commonly reported after ingestion of seafood. We report a case of palytoxin poisoning from dermal absorption with local toxicity from... |
SourceID | proquest crossref pubmed elsevier |
SourceType | Aggregation Database Index Database Publisher |
StartPage | 397 |
SubjectTerms | Acrylamides - poisoning Adult Animals Anthozoa Cnidarian Venoms - poisoning coral Emergency Female Humans palytoxin Skin Absorption zoanthid |
Title | Palytoxin Poisoning After Dermal Contact with Zoanthid Coral |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S0736467909003357 https://dx.doi.org/10.1016/j.jemermed.2009.05.004 https://www.ncbi.nlm.nih.gov/pubmed/19545971 https://search.proquest.com/docview/1356924787 |
Volume | 40 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpR1LS8Mw-GNOEC_i2_kYFbx2S9skbcDL8MFUlIEOhpeQPoIboxVXQS_-dr-sqQ9EPHgNTdN-73xPgKOUR55CWnAjQbVLNSWuUEq5QeSrhGuOdyJT73x9w_tDejliowac1LUwJq3Syv5Kps-ltV3pWmh2H8fj7i0SJ0c2F8Q44wIWLsAiqiNKm7DYu7jq33wEE0Iyn1VqnnfNhi-FwpPOxNThouKxrSuNh4X-pqN-s0Hnuuh8FVasEen0qu9cg0aWr8PStQ2Tb8DxQE1fy-JlnDuDwqQLoX5yemYauHNqJPHUMU2pVFI6xg3r3BcI3odxiqtParoJw_Ozu5O-a8ckuAllrHRpookK0HLhGeMqxiufYDHTYUhSEiC7aS6iUERaBTyLEi38KCXMR8s69tM4VTzYgmZe5NkOODpAlPJE4Ctj00UyThF7YZB6PiI6InELujVg5GPVDUPWaWITWYPSjLYUkjCJoGxBWMNP1rWeKJ2ymWWVmfTkzJdE_kBnC8THzm8UIVHY_3nqYY0qiexiYiAqz4pnPA0BhVdOFFMt2K5w-PknAs1JEXq7_zh5D5Yrr7PJ7dmHZvn0nB2g2VLGbVjovHltS5zvjvnq1w |
link.rule.ids | 315,786,790,4521,24144,27955,27956,45618,45712 |
linkProvider | Elsevier |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpR3JSsNA9OEC6kXcrWsEr2kny0wy4EVcqEtLQYXiZZgsgy0lERtBL3677zWJCyIevA6TvOTt8-YtAIeJCB2NvGCH0je2b3xmS6217YWujoUReCaieudOV7Tv_Ms-70_BSV0LQ2mVle4vdfpEW1crrQqbrcfBoHWDzClQzCWjYJzHg2mYJW-A8rqabx95Hk7AJpNKabdN27-UCQ-bQ6rCRbNTNa6k-Ir_m4X6zQOdWKLzJVisXEjruPzKZZhKsxWY61SX5Ktw1NOj1yJ_GWRWL6dkIbRO1jHNArdOSQ-PLGpJpePCoiCsdZ8jch8GCa4-6dEa3J2f3Z607WpIgh37nBe2HxumPfRbRMqFjvDAJ3nETRCwhHkobEbIMJCh0Z5Iw9hIN0wYd9GvjtwkSrTw1mEmy7N0EyzjIUFFLPGVEfWQjBKkXeAljotkDlnUgFaNGPVY9sJQdZLYUNWopMGWUjGuEJUNCGr8qbrSE3VTOq4EZawcNXYVUz-I2QD58eQ3flCo6v-EelCTSqGw0A2IztL8GaEhovDAiUqqARslDT__RKIzKQNn6x-Q92G-fdu5VtcX3attWCjjz5TlswMzxdNzuosOTBHtTRj0HaLa66w |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Palytoxin+Poisoning+After+Dermal+Contact+with+Zoanthid+Coral&rft.jtitle=The+Journal+of+emergency+medicine&rft.au=Nordt%2C+Sean+Patrick&rft.au=Wu%2C+Jerry&rft.au=Zahller%2C+Stephen&rft.au=Clark%2C+Richard+F.&rft.date=2011-04-01&rft.pub=Elsevier+Inc&rft.issn=0736-4679&rft.eissn=2352-5029&rft.volume=40&rft.issue=4&rft.spage=397&rft.epage=399&rft_id=info:doi/10.1016%2Fj.jemermed.2009.05.004&rft.externalDocID=S0736467909003357 |
thumbnail_m | http://utb.summon.serialssolutions.com/2.0.0/image/custom?url=https%3A%2F%2Fcdn.clinicalkey.com%2Fck-thumbnails%2F07364679%2FS0736467911X00045%2Fcov150h.gif |