Scombroid
Revision as of 13:12, 13 July 2015 by Neil.m.young (talk | contribs)
Background
- Common in Hawaii, then FL
- Frequently misdiagnosed as seafood allergy
- Most of the cases associated with tuna, bluefish, and mahi-mahi
- Also herring, mackerel, skip-jack, sardine, and bonito
- Bacteria in fish produce produce heat-stable toxins causing histamine release when consumed[1]
Clinical Presentation
- Fish dish taste metallic, bitter, or peppery[2]
- Starts within one hour of ingestion
- Flushing, warmth, erythematous rash, palpitations, dizziness, diarrhea within 30 min of consumption
- Severe throbbing headache, blurred vision, dizziness
- Significant tachycardia, palpitations, and possible respiratory distress
- 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
Source
- ↑ Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222
- ↑ Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222