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Scombroid Fish Poisoning
Aka: Scombroid Fish Poisoning, Scombroid Poisoning, Scombroid Toxicity
- Epidemiology
- More common in Hawaii and California
- Pathophysiology
- Improper handling of fish (delay to refrigeration)
- Unrefrigerated Tuna, Mahi-mahi,or mackerel
- Histidine converted to histamine by marine bacteria
- Isoniazid potentiates this reaction
- Symptoms (Related to histamine release)
- Severe Flushing
- Nausea
- Vomiting
- Diarrhea
- Severe Headache
- Palpitations
- Abdominal Pain
- Urticaria
- Course
- Onset within 20-30 minutes of ingestion
- Resolves within 6-8 hours
- Management
- Diphenhydramine (Benadryl) 50 mg IV/IM}PO
- Consider H2 Receptor Blocker (Ranitidine, Cimetidine)
- Consider inducing Emesis in severe cases