Difference between revisions of "Scombroid"

(Source)
(clinical info, backgroun, reference)
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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 tuna, mackerel, skip-jack, and bonito
+
**Also herring, mackerel, skip-jack, sardine, and bonito
*Bacteria in fish produce histamine that is then consumed
+
*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==
*flushing, warmth, erythematous rash, palpitations, and significant tachycardia
+
*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>
*Occasionally headache, blurred vision, respiratory distress, and dizziness
 
 
*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

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