Scombrotoxic fish poisoning overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Scombrotoxic fish poisoning, also known as scombroid toxicity or scombrotoxic poisoning is a form of food poisoning. It is caused by histamine and histamine-like products of bacterial breakdown of seafood, inhibiting its metabolism. The exact aetiology is complicated as histamine is not generally absorbed via the gut and administration of oral histamine does not replicate the symptoms. Foods notably associated with it are: tuna, mackerel, and bonito.

Pathophysiology

Scombrotoxic fish poisoning is caused by bacterial spoilage of certain finfish such as tuna, mackerel, bonito, and, rarely, other fish. As bacteria break down fish proteins, byproducts such as histamine and other substances that block histamine breakdown build up in fish.

Epidemiology and Demographics

Eating spoiled fish that have high levels of histamines can cause human disease.

Risk Factors

Symptoms may be more severe in patients taking certain medications that slow the breakdown of histamine by their liver, such as isoniazide and doxycycline.

Diagnosis

History and Symptoms

The most common symptoms are; rash, diarrhea, flushing, sweating, headache and vomiting.

Medical Therapy

Treatment is generally unnecessary, but antihistamines or epinephrine may be needed in certain instances.

References

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/marinetoxins_g.htm