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

More general terms

• food poisoning (foodborne disease)