Scombrotoxic fish poisoning

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

Synonyms: Scombroid or histamine fish poisoning

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
• Mackeral
• Bonito

References

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

Epidemiology and Demographics

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

References

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

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.

References

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

Pathophysiology & Etiology

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.

References

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

History and Symptoms

Symptoms begin within 2 minutes to 2 hours after eating the fish.

The most common symptoms are:

• rash
• diarrhea
• flushing
• sweating
• headache
• vomiting

Burning or swelling of the mouth, abdominal pain, or a metallic taste may also occur. The majority of patients have mild symptoms that resolve within a few hours.

References

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

Treatment

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

Acute Pharmacotherapies

References

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

Acknowledgements

The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.