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A rare case of food poisoning by Kudoa hexapunctata
  1. Yoshihito Takashima,
  2. Tsuyoshi Suda,
  3. Naoki Oishi and
  4. Eiki Matsushita
  1. Gastroenterology, Kanazawa Municipal Hospital, Kanazawa, Japan
  1. Correspondence to Dr Tsuyoshi Suda; t.suda1112{at}

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A 32-year-old man was admitted to our hospital at midnight with vomiting and diarrhoea after eating sashimi for dinner. On physical examination, his abdomen was flat and tender with weak peristalsis, but no rebound tenderness or abdominal rigidity. He was febrile with a temperature of 38.2°C. Blood tests revealed an elevated white cell count (16×10⁹/L), with all other parameters, including C-reactive protein, within the normal range. The fever, vomiting and diarrhoea resolved within 24 hours.

Spores of Kudoa species were detected in a stool culture.

Kudoa’s spores are surrounded by three or more shell valves that are symmetrically radial, each having one polar capsule. The suture line where the shells meet is often indistinct (figure 1). PCR testing confirmed the presence of Kudoa hexapunctata, a mucus sporozoite that is found in bluefin tuna (especially young bigeye tuna); it was taxonomically separated from Kudoa neothunni (which is found in yellowfin tuna) and other species since tuna is their primary host.1 Kudoa food poisoning is associated with the consumption of raw fresh fish, such as sashimi. It manifests as diarrhoea and vomiting within 12 hours of eating the contaminated food and usually resolves within 24 hours.2

Figure 1

A spore surrounded by three or more shell valves, symmetrically radial, with a polar capsule each, detected in a stool culture.

Learning points

  • Kudoa food poisoning is associated with raw fresh fish consumption.

  • It manifests as diarrhoea and vomiting within 12 hours of eating the contaminated food.

  • It usually resolves within 24 hours.

Ethics statements

Patient consent for publication


We are grateful to Mrs Yuka Umeda and Mrs Riho Matsuoka (Kanazawa Municipal Hospital,Clinical Laboratory Center) for helping with a bacteriological examination.



  • Contributors YT cared for the patient, edited the manuscript and prepared the figure. TS cared for the patient, conducted the literature search and edited the manuscript. NO and EM edited the manuscript and gave the expert opinion of gastroenterology.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.