... The cases occur worldwide, but the majority of reported cases have occurred in the United States. The presenting symptoms are most commonly dyspnea, 3,9,22,24,25,27,28,[30][31][32] chest pain, 3,22,27 cough, 24,25,27,28,30,32,34 tachycardia, 3,9,24,27,28,30,33 nausea and/or vomiting, 3,27,29,30,33 headaches, 3,30 fever, 9,24,25,[28][29][30][31][32][33] and myalgia or weakness. 9,25,26,28,29,31,32 Since there is no antitoxin for PTX all patients received symptomatic treatment and all recovered within one month with three exceptions (one patient recovered in three months, one had recurring symptoms after two years, and one had permanent neurologic damage and respiratory symptoms after seven years of follow-up). ...