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Abstract
Horseshoe Crab Poisoning: Report of Four Cases and the Results of Treatment with Thunbergia
laurifolia
Supannee Praditsathawong*
*Chumphon Khetudomsakdi Hospital, Chumporn Province
Poisoning was reported in patients of the same family group after they had eaten tetrodotoxin-contami-
nated horseshoe crab eggs. The severity of the symptoms varied depending on the amount of toxic eggs
consumed. The onset of the first symptoms varied from 40 minutes to 4 hours. All four patients experienced
numbness around the mouth, nausea and vomiting. In the severe cases, the numbness spread to all muscles
and difficulty in breathing occurred. Two patients went into coma and required endotracheal tubation with
mechanical ventilation. As there is no specific antidote for tetrodotoxin, all patients were given symptomatic
and supportive treatment while the toxin was excreted in the urine. Nine hours after going into a coma, the
patients were given rang cherd (Thunbergia laurifolia Lindl.) leaf juice. Forty minutes after the administra-
tion of the herbal medicine, the patients regained consciousness and gradually recovered. Clinical manifesta-
tions of horseshoe crab poisoning, toxicity of the horseshoe crab and the effect of rang cherd in these patients
were discussed.

Key words: horseshoe crab, tetrodotoxin poisoning, rang cherd, Thunbergia laurifolia Lindl.