Suspected tetrodotoxin (TTX) poisoning was associated with eating unknown fish 
in April 2009 in Taiwan. After ingestion of the fish, symptoms of the victim 
included perioral paresthesia, nausea, vomiting, ataxia, weakness of all limbs, 
respiration failure, and death within several hours. The toxicity in the 
remaining fish was determined, with the mice exhibiting symptoms of neurotoxin 
poisoning. The implicated fish and deceased victim tissues were analyzed for TTX 
by liquid chromatography-tandem mass spectrometry. The urine, bile, 
cerebrospinal fluid (spinal cord), pleural effusion, and pericardial effusion of 
the victim contained TTX. In addition, the partial cytochrome b gene of the 
implicated fish was determined by PCR. The DNA sequence in the partial 465-bp 
cytochrome b gene identified the implicated fish as Chelonodon patoca (puffer 
fish). These results indicate that people should avoid eating unknown fish 
species from fish markets where harvested fish may include toxic species.