Scombroid: Difference between revisions
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==Background== | ==Background== | ||
* | *Caused by eating fish which have been improperly stored/refrigerated | ||
**Bacteria grow and produce heat-stable toxin that causes histamine release when consumed<ref name="Craig">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> | |||
**Patient may complain that the fish tasted like pepper, metallic, or bitter | |||
*Commonly associated fish include: tuna, bluefish, mahi-mahi, herring, mackerel, skip-jack, sardine, and bonito | |||
*Frequently misdiagnosed as seafood allergy | *Frequently misdiagnosed as seafood allergy | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
* | *Symptoms generally start within one hour of ingestion, and usually resolves within 12 hours (if untreated) | ||
*Flushing, warmth, erythematous rash, palpitations, dizziness, diarrhea | |||
*May also see severe throbbing headache, blurred vision, tachycardia, and respiratory distress | |||
* | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 18: | Line 15: | ||
{{Template:Acute Allergic DDX}} | {{Template:Acute Allergic DDX}} | ||
==Diagnosis == | ==Diagnosis== | ||
*Generally clinical diagnosis | |||
== | ==Management== | ||
*H1 and H2 | *Antihistamines - give both H1 and H2 antagonists | ||
* | *Consider epinephrine, albuterol if sx of respiratory distress | ||
==Disposition== | |||
*Generally may be discharged | |||
==See Also== | ==See Also== | ||
*[[Marine toxins and envenomations]] | *[[Marine toxins and envenomations]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Environmental]] | [[Category:Environmental]] | ||
Revision as of 03:58, 4 April 2016
Background
- Caused by eating fish which have been improperly stored/refrigerated
- Bacteria grow and produce heat-stable toxin that causes histamine release when consumed[1]
- Patient may complain that the fish tasted like pepper, metallic, or bitter
- Commonly associated fish include: tuna, bluefish, mahi-mahi, herring, mackerel, skip-jack, sardine, and bonito
- Frequently misdiagnosed as seafood allergy
Clinical Presentation
- Symptoms generally start within one hour of ingestion, and usually resolves within 12 hours (if untreated)
- Flushing, warmth, erythematous rash, palpitations, dizziness, diarrhea
- May also see severe throbbing headache, blurred vision, tachycardia, and respiratory distress
Differential Diagnosis
- Ciguatera - similar clinical presentation, different fish
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
- Generally clinical diagnosis
Management
- Antihistamines - give both H1 and H2 antagonists
- Consider epinephrine, albuterol if sx of respiratory distress
Disposition
- Generally may be discharged
See Also
References
- ↑ 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