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scombroid fish poisoning
Etiology:
- cooked, smoked, canned, or raw fish from temperate or tropical waters
Pathology:
- bacteria commonly found on the surface of the fish contain a heat-stable histidine decarboxylase enzyme that acts on warm (not refrigerated), freshly killed fish, converting histidine to histamine
- scombrotoxin may be histamine
Clinical manifestations:
- onset of symptoms 10-60 minutes after ingestion of contaminated fish
- cutaneous manifestations
- intense. diffuse. blanching erythema of the face, neck & upper torso
- rarely, pruritus, urticaria, angioedema
- scleral erythema
- headache, palpitations, blurred vision, GI distress
- symptoms often resolve without treatment within 12 hours
Management:
- supportive care
- IV fluids, antiemetics, antihistamines
General
food poisoning (foodborne disease)
References
- Harmon J, Kapitanyan R
Poisoning Clues on the Skin: 10 Cases
Medscape. April 6, 2017
http://reference.medscape.com/features/slideshow/acutepoisonings
- Harmon J, Kapitanyan R
Poisoning Clues on the Skin: 8 Cases.
Medscape. March 8, 2021
https://reference.medscape.com/slideshow/poisoning-clues-6013719