Scombrotoxic fish poisoning
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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.