A review of the features and pathogenesis of the syndrome is presented. [ncbi.nlm.nih.gov]

• Malnutrition

  In particular, Belinda has a broad range of experience with weight management, diabetes, oncology, high cholesterol, malnutrition, childhood nutrition and gastrointestinal disorders. [entwellbeing.com.au]

• Dyspnea

  […] pain Pruritus of skin, hives (without wealing or skin swelling) Palpitations, an unusual “thumping, pounding heart sensation” Dizziness, lightheadedness, blurred vision Dry mouth, swelling of tongue and face And rarely chest tightness and possibly even dyspnea [jfsem.org]

• Pharyngitis

  Other symptoms included nausea, vomiting, sweating, burning throat, pharyngeal constriction, peppery taste, and abdominal cramps. All symptoms resolved within 24 hours of onset. [cdc.gov]

• Nausea

  Clinical manifestation consisted of hyperemia, particularly on the face and neck (94.7%), nausea and vomiting (17.0%), abdominal pain (17.0%), pruritus (4.3%), headache and dizziness (4.3%) and diarrhea (3.2%). [ncbi.nlm.nih.gov]

  After consuming contaminated mussels or clams, a person will most likely experience nausea, vomiting and diarrhea. [disabled-world.com]

  Symptoms usually develop immediately after eating and can include flushing, hives and itching, nausea, vomiting, diarrhea and, in severe cases, breathing problems. [drweil.com]

  Spoiled fish, the result of poor food handling practices, can also cause dramatic gastrointestinal symptoms – nausea, vomiting, diarrhea, and abdominal pain. [poison.org]

  Scombroid Poisoning Symptoms Symptoms of scombroid poisoning generally begin 1 hour after ingestion of the poison and include: Nausea Vomiting Flushing Abdominal cramps Diarrhea Headache. [webmd.com]

• Vomiting

  Clinical manifestation consisted of hyperemia, particularly on the face and neck (94.7%), nausea and vomiting (17.0%), abdominal pain (17.0%), pruritus (4.3%), headache and dizziness (4.3%) and diarrhea (3.2%). [ncbi.nlm.nih.gov]

  […] might receive medication to stop the vomiting, as well as IV fluids to replace lost fluids from vomiting and diarrhea. [disabled-world.com]

  Treatment includes medication to stop the vomiting, IV fluids to replace those lost from vomiting and diarrhea, and in severe cases the drug mannitol to help reduce neurological symptoms such as dizziness, numbness and misperception of cold. [drweil.com]

  Moreover, patients are often given IV fluids as they may become dehydrated from vomiting. [emedicinehealth.com]

  If symptoms continue, your doctor may tell you to take either an antihistamine or a medicine to prevent vomiting, or both. [mountnittany.org]

• Food Poisoning

  The diagnosis of scombroid fish poisoning could be misdiagnosed as food allergy or bacterial food poisoning if physicians are not aware of such poisoning. [ncbi.nlm.nih.gov]

  Scombroid food poisoning Other names Scombrotoxin fish poisoning, scombroid syndrome, Seafood Network Information Center Center for Disease Control: Food Poisonings from Marine Toxins DermNet reactions/scombroid [en.wikipedia.org]

  This type of food poisoning is not caused by a virus or bacteria. Symptoms of scombroid poisoning The symptoms of this particular type of food poisoning appear very quickly. In some cases, they occur within a few minutes of eating the infected fish. [medic8.com]

  Bigeye Tuna Scombroid poisoning from fish is a common type of food poisoning. We are all aware of food poisonings due to E. coli, salmonella, and natural toxins from mushrooms and pufferfish, but scombroid poisoning is a bit different. [naturespoisons.com]

  More Information Food Poisoning from Marine Toxins [wwwnc.cdc.gov]

• Diarrhea

  Clinical manifestation consisted of hyperemia, particularly on the face and neck (94.7%), nausea and vomiting (17.0%), abdominal pain (17.0%), pruritus (4.3%), headache and dizziness (4.3%) and diarrhea (3.2%). [ncbi.nlm.nih.gov]

  Symptoms usually develop immediately after eating and can include flushing, hives and itching, nausea, vomiting, diarrhea and, in severe cases, breathing problems. [drweil.com]

  After consuming contaminated mussels or clams, a person will most likely experience nausea, vomiting and diarrhea. [disabled-world.com]

  Spoiled fish, the result of poor food handling practices, can also cause dramatic gastrointestinal symptoms – nausea, vomiting, diarrhea, and abdominal pain. [poison.org]

• Abdominal Cramps

  The clinical picture is secondary to histamine toxicity, manifested as flushing, headache, palpitations, and abdominal cramps. The diagnosis is established on the basis of these typical clinical manifestations and fish-ingestion history. [ncbi.nlm.nih.gov]

  Scombroid Poisoning Symptoms Symptoms of scombroid poisoning generally begin 1 hour after ingestion of the poison and include: Nausea Vomiting Flushing Abdominal cramps Diarrhea Headache. [webmd.com]

  Symptoms of scombroid poisoning typically include facial flushing, sweating, rash, a burning or peppery taste in the mouth, diarrhea and abdominal cramps. Symptoms usually disappear within several hours without medical intervention. [epi.publichealth.nc.gov]

  Symptoms included skin rash (two persons), headache (two), diarrhea (three), and abdominal cramping (three), with onset occurring 35--150 minutes after tuna consumption. [cdc.gov]

• Hypotension

  About 25% had abnormal vital signs; two patients developed hypotension. Treatment was supportive and included mainly H1-antagonists (65.2%) and fluids (13%). [ncbi.nlm.nih.gov]

  When to Seek Medical Care for Scombroid Poisoning A severe or prolonged reaction ( hypotension, shortness of breath, tongue or throat swelling) requires medical treatment as soon as possible; this could be a medical emergency. [emedicinehealth.com]

  Physical signs may include a diffuse blanching erythema, tachycardia, wheezing and hypotension or hypertension. People with asthma are more vulnerable to respiratory problems such as wheezing or bronchospasm. [entwellbeing.com.au]

  Beta agonists, epinephrine and intravenous hydration may be administered to treat any serious effects such as angioedema, wheezing or hypotension. [calpoison.org]

• Weak Pulse

  The usual symptoms for scombroid fish poisoning were observed in cases, i.e. flushing (85.9%), headache (83.1%), rapid/weak pulse (59.1%) and diarrhoea (47.9%). Symptoms occurred from within a few minutes to up to 3 h following the meal. [ncbi.nlm.nih.gov]

• Conjunctival Injection

  She had conjunctival injection and a diffusely erythematous blanching rash on her face, neck, trunk and extremities. Her exam was otherwise unremarkable. She was treated with PO ranitidine and diphenhydramine with improvement in her symptoms. [calpoison.org]

• Flushing

  Onset of the reaction is usually abrupt and commonly associated with a prominent flush resembling a sunburn. [ncbi.nlm.nih.gov]

• Urticaria

  The rash is a form of urticaria, but unlike an allergic reaction, there is no wealing (skin swelling). [dermnetnz.org]

  CLINICAL FEATURES Histamine does not change the smell or appearance of the affected fish Symptoms begin within 10 to 90 minutes after ingestion flushing, rash, urticaria (generally widespread erythema, usually lacking wheals), palpitations, headache, [lifeinthefastlane.com]

  […] burning-peppery taste sensations in the mouth and throat dizziness nausea headache tachycardia cold-like symptoms Additional symptoms The above symptoms can advance to: facial rash torso or body rash: The rash associated with scombroid poisoning is a form of urticaria [entwellbeing.com.au]

  About 15 minutes after ingestion all had begun to experience generalised urticaria, palpitations, and felt hot. None had a history of urticaria or hypersensitivity. On arrival three of five patients were tachycardic and tachypnoeic. [emj.bmj.com]

  Facial flushing and possibly nausea, vomiting, epigastric pain, and urticaria occur within a few minutes of eating and resolve within 24 h. Symptoms are often mistaken for those of a seafood allergy. [merckmanuals.com]

• Pruritus

  Clinical manifestation consisted of hyperemia, particularly on the face and neck (94.7%), nausea and vomiting (17.0%), abdominal pain (17.0%), pruritus (4.3%), headache and dizziness (4.3%) and diarrhea (3.2%). [ncbi.nlm.nih.gov]

  She also complained of pruritus and a restless feeling. Her face became flushed soon after her meal. Her friend who also ate tuna had similar symptoms. The patient was healthy with no medical problems. [calpoison.org]

  Abdominal cramps, nausea, vomiting, and diarrhea last 6 to 17 h; then, pruritus, paresthesias, headache, myalgia, reversal of hot and cold sensation, and face pain may occur. [merckmanuals.com]

  Throbbing generalized headache Nausea and vomiting Diarrhea Generalized abdominal cramps, following initial Epigastric pain Pruritus of skin, hives (without wealing or skin swelling) Palpitations, an unusual “thumping, pounding heart sensation” Dizziness [jfsem.org]

  […] acute neurological disease manifested by transient gastrointestinal symptoms (diarrhea, abdominal cramps, and vomiting) occurring within 12 hours of ingestion, followed within hours by neurological symptoms (perioral and limb paresthesia, tooth pain, pruritus [the-travel-doctor.com]

• Erythema

  CLINICAL FEATURES Histamine does not change the smell or appearance of the affected fish Symptoms begin within 10 to 90 minutes after ingestion flushing, rash, urticaria (generally widespread erythema, usually lacking wheals), palpitations, headache, [lifeinthefastlane.com]

  Physical signs may include a diffuse blanching erythema, tachycardia, wheezing and hypotension or hypertension. People with asthma are more vulnerable to respiratory problems such as wheezing or bronchospasm. [entwellbeing.com.au]

  Erythema was noted over all their faces and trunk. The concurrent presentation of five such cases to A&E roused the suspicion of the attending registrar who diagnosed histamine fish poisoning. [emj.bmj.com]

  Symptoms of histamine fish poisoning may also include: Flushing of skin, with deep confluent erythema unusually on upper body, and exacerbated by ultraviolet light or tanning beds. [jfsem.org]

• Skin Rash

  All cases experienced flush, dizziness, blurred vision and skin rashes after eating lunch. A non-scombroid fish of Makaira with histamine levels as high as 84.13 mg/100 g flesh was implicated in this incident. [ncbi.nlm.nih.gov]

  Symptoms included skin rash (two persons), headache (two), diarrhea (three), and abdominal cramping (three), with onset occurring 35--150 minutes after tuna consumption. [cdc.gov]

• Headache

  The clinical picture is secondary to histamine toxicity, manifested as flushing, headache, palpitations, and abdominal cramps. The diagnosis is established on the basis of these typical clinical manifestations and fish-ingestion history. [ncbi.nlm.nih.gov]

In addition, elevated histamine levels can be measured in patients’ urine. [4, 5] (See Workup .) An example of a typical histamine toxicity rash, in this case from tuna. Image courtesy of Amanda Oakley, MBChB, FRACP. [emedicine.medscape.com]

The treatment was without sequelae and permitted early discharge from the emergency department. A brief review of scombroid fish poisoning and its treatment is provided. [ncbi.nlm.nih.gov]

Treatment is in the form of supportive care such as fluids and oxygen. [entwellbeing.com.au]

Treatment Treatment is generally unnecessary, but antihistamines or epinephrine may be needed in certain instances. Prevention Always keep seafood refrigerated or on ice to prevent spoilage. [bouldercounty.org]

Unless complicated with shock or respiratory distress, supportive treatment with antihistamines usually concludes with a good prognosis. Toxin analysis of the fish flesh remains the most important step in approaching a confirmed diagnosis. [ncbi.nlm.nih.gov]

Prognosis The symptoms can be extremely uncomfortable but generally are not fatal and resolve within 12 hours [1]. [entwellbeing.com.au]

During 2009-2015, 85 outbreaks of confirmed histamine fish poisoning involving 250 illnesses were reported to the CDC, with one hospitalizaiton and no deaths. [14] Prognosis Patients with histamine fish toxicity have a good prognosis. [emedicine.medscape.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Other postulated second agents are cadaverine or putrescine. [9, 10] Etiology The fish species most commonly implicated in histamine toxicity are scombroid dark-meat fish (eg, tuna, mackerel, skipjack, bonito, marlin) and nonscombroid species, such as [emedicine.medscape.com]

A wide variety of etiologic agents may be responsible, including toxins, bacteria, viruses, and parasites. It is incumbent on the travel medicine practitioner to advise travelers on ways to avoid seafood poisoning. [the-travel-doctor.com]

He was diagnosed after presentation of two similar patients with the same epidemiological history. [ncbi.nlm.nih.gov]

In this review, we discuss the epidemiology, pathophysiology, evaluation, and treatment of scombroid disease. [ncbi.nlm.nih.gov]

Pathophysiology and pharmacokinetics The incubation period for scombroid is relatively short (a few minutes to a few hours). Spoilage bacteria can produce substantial amounts of histamine in fish kept at temperatures above 4 C for 3-5 hours. [calpoison.org]

Pathophysiology Histamine poisoning directly relates to improper preservation and inadequate refrigeration. [emedicine.medscape.com]

Written by: G eorge Schroeder MD, MS, FACEP, FAAUCM Clinical Assistant Professor of Emergency Medicine UCF College of Medicine, Orlando, Florida Pathophysiology Scombroid ichthyotoxicosis or Scombroid fish poisoning consists of seafood-related food-borne [jfsem.org]

The only effective method for prevention of scombroid fish poisoning is consistent temperature control of fish at [ncbi.nlm.nih.gov]

Fish poisoning – symptoms, treatment and prevention. December 2013. Ansdell V. Food Poisoning from marine Toxins. Centers for Disease Control and Prevention. August 2013. [entwellbeing.com.au]

Prevention Refrigerate seafood at less than 38 F (3.3 C) to prevent it from spoiling. Don't eat fish that you think may be spoiled or poorly refrigerated. Don't eat fish if it has an unusual peppery bitter taste. [mountnittany.org]