Scombroid

Background

• Frequently misdiagnosed as seafood allergy
• Most of the cases associated with tuna, bluefish, and mahi-mahi
  • Also tuna, mackerel, skip-jack, and bonito
• Bacteria in fish produce histamine that is then consumed

Clinical Presentation

• flushing, warmth, erythematous rash, palpitations, and significant tachycardia
• Occasionally headache, blurred vision, respiratory distress, and dizziness
• Starts within one hour of ingestion
• Usually resolves within 12 hours if untreated and has no long-term sequelae

Differential Diagnosis

Acute allergic reaction

• Allergic reaction/urticaria
• Anaphylaxis
• Angioedema
• Anxiety attack
• Asthma exacerbation
• Carcinoid syndrome
• Cold urticaria
• Contrast induced allergic reaction
• Scombroid
• Shock
• Transfusion reaction

Diagnosis

Usually clinical

Treatment

• H1 and H2 agonists
• Epi and albuterol if bronchospasm

See Also

• Marine toxins and envenomations

Source

UpToDate