Emergency Medicine Book


Scombroid Fish Poisoning

Aka: Scombroid Fish Poisoning, Scombroid Poisoning, Scombroid Toxicity, Scombroid
  1. Epidemiology
    1. More common in Hawaii and California
  2. Pathophysiology
    1. Improper handling of fish (delay to refrigeration)
      1. Unrefrigerated dark meat fish such as Tuna, Mahi-mahi,or mackerel
      2. Food typically tastes atypical
    2. Histidine converted to histamine by marine Bacteria
    3. Isoniazid potentiates this reaction
  3. Symptoms (Related to histamine release)
    1. Severe Flushing including facial Flushing
    2. Nausea
    3. Vomiting
    4. Diarrhea
    5. Severe Headache
    6. Palpitations
    7. Abdominal Pain
    8. Urticaria
    9. Bronchospasm with Wheezing
  4. Course
    1. Onset within 20-30 minutes of ingestion
    2. Resolves within 6-8 hours
  5. Management
    1. Antihistamine
      1. Diphenhydramine (Benadryl) 50 mg IV/IM}PO
      2. Consider H2 Receptor Blocker (Ranitidine, Cimetidine)
    2. Nebulized Albuterol
      1. Indicated for bronchospasm
    3. Consider inducing Emesis in severe cases

Scombroid fish poisoning (C0275143)

Concepts Injury or Poisoning (T037)
ICD10 T61.1
SnomedCT 212866009, 241773001, 83227006
English Scombroid fish caus tox effect, Toxic eff/scombroid fish poisn, scombroid poisoning (diagnosis), scombroid poisoning, scombroid fish poisoning, histamine fish poisoning, Scombroid fish causing toxic effect (event), Scombroid fish causing toxic effect (disorder), Scombroid fish poisoning, Histamine fish poisoning, Scombroid fish causing toxic effect, Toxic effect of scombroid fish poisoning, Scombroid fish poisoning (disorder), poisoning; scombroid fish, scombroid fish; poisoning
German Scombroid-Fischvergiftung
Korean 스콤브로이드 물고기 중독
Dutch scombroïdvis; vergiftiging, vergiftiging; scombroïdvis, Vergiftiging door scombroïdvis
Spanish intoxicación por pescado escombroideo (trastorno), intoxicación por pescado escombroideo
Derived from the NIH UMLS (Unified Medical Language System)

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