Scombroid: Difference between revisions
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==Background== | ==Background== | ||
*Common in Hawaii, then FL | |||
*Frequently misdiagnosed as seafood allergy | *Frequently misdiagnosed as seafood allergy | ||
*Most of the cases associated with tuna, bluefish, and mahi-mahi | *Most of the cases associated with tuna, bluefish, and mahi-mahi | ||
**Also | **Also herring, mackerel, skip-jack, sardine, and bonito | ||
*Bacteria in fish produce histamine | *Bacteria in fish produce produce heat-stable toxins causing histamine release when consumed<ref>Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222</ref> | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
* | *Fish dish taste metallic, bitter, or peppery<ref>Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222</ref> | ||
*Starts within one hour of ingestion | *Starts within one hour of ingestion | ||
**Flushing, warmth, erythematous rash, palpitations, dizziness, diarrhea | |||
**Severe throbbing headache, blurred vision, dizziness | |||
**Significant tachycardia, palpitations, and possible respiratory distress | |||
*Usually resolves within 12 hours if untreated and has no long-term sequelae | *Usually resolves within 12 hours if untreated and has no long-term sequelae | ||
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==Source== | ==Source== | ||
UpToDate | *UpToDate | ||
*Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222 | |||
[[Category:Derm]] | [[Category:Derm]] | ||
[[Category:Environ]] | [[Category:Environ]] | ||
Revision as of 02:55, 13 January 2015
Background
- Common in Hawaii, then FL
- Frequently misdiagnosed as seafood allergy
- Most of the cases associated with tuna, bluefish, and mahi-mahi
- Also herring, mackerel, skip-jack, sardine, and bonito
- Bacteria in fish produce produce heat-stable toxins causing histamine release when consumed[1]
Clinical Presentation
- Fish dish taste metallic, bitter, or peppery[2]
- Starts within one hour of ingestion
- Flushing, warmth, erythematous rash, palpitations, dizziness, diarrhea
- Severe throbbing headache, blurred vision, dizziness
- Significant tachycardia, palpitations, and possible respiratory distress
- Usually resolves within 12 hours if untreated and has no long-term sequelae
Differential Diagnosis
Acute allergic reaction
- Allergic reaction/urticaria
- Anaphylaxis
- Angioedema
- Anxiety attack
- Asthma exacerbation
- Carcinoid syndrome
- Cold urticaria
- Contrast induced allergic reaction
- Scombroid
- Shock
- Transfusion reaction
Diagnosis
Usually clinical
Treatment
- H1 and H2 agonists
- Epi and albuterol if bronchospasm
See Also
Source
- UpToDate
- Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222
- ↑ Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222
- ↑ Craig SA, Zich DK: Gastroenteritis, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 92:p 1211-1222