Palytoxin (PTX) is a heat-stable aquatic neurotoxin produced by marine red algal dinoflagellates, anemones, corals, and crustaceans. Exposure can be secondary to physical contact or inhalation.

The mechanisms of PTX poisoning include sodium / potassium adenosine triphosphatase (ATPase) channel opening effects that prolong depolarization, causing muscle spasms with myofilament damage and release of muscle enzymes.

Patients typically present within 8-16 hours of ingestion or inhalation exposure with a metallic taste in the mouth, vomiting, abdominal cramps, diarrhea, circumoral and peripheral paresthesias, muscle weakness, seizures, pruritic skin eruptions, chest pain, cough, dyspnea, hypertension, or myoglobinuria.