Regarded by many as a delicacy, puffer fish can be the source of lethal food poisoning in humans. The syndrome is caused by tetrodotoxin, one of the most potent poisons known. Intoxication produces a constellation of symptoms, with paresthesias and generalized muscle weakness being common complaints. Treatment is symptomatic and often needs to be aggressive. Life support may be required. In some series, the mortality rate has approached 60 percent.