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Scombroid (histamine) poisoning

Erin N Marcus, MD, MPH, FACP
Section Editors
Daniel F Danzl, MD
Stephen J Traub, MD
Michele M Burns, MD, MPH
Deputy Editor
James F Wiley, II, MD, MPH


Scombroid poisoning is a common seafood-associated disease throughout the world [1,2]. It may also occur after consumption of contaminated Swiss cheese. The most common findings consist of a rapid onset of flushing of the face and neck, erythematous and urticarial rash, diarrhea, and headache occurring soon after consumption of contaminated fish or cheese. Rarely, severe bronchospasm or cardiac effects may occur in patients with predisposing conditions, such as asthma or heart disease. Because of its clinical presentation, it is frequently misdiagnosed as seafood allergy. For most patients, management consists of treatment with H1 or H2 antihistamines. Patients with life-threatening airway edema, bronchospasm, or distributive shock warrant treatment as for anaphylaxis (table 1 and table 2) [3].

This topic will discuss the clinical manifestations, diagnosis, and management of scombroid (histamine) poisoning. Other microbial and marine foodborne diseases are discussed separately:

(See "Differential diagnosis of microbial foodborne disease".)

(See "Ciguatera fish poisoning".)

(See "Overview of shellfish and pufferfish poisoning".)


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Literature review current through: Sep 2016. | This topic last updated: Nov 2, 2015.
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