Scombroid (histamine) poisoning
- Erin N Marcus, MD, MPH, FACP
Erin N Marcus, MD, MPH, FACP
- Associate Professor of Clinical Medicine
- University of Miami Miller School of Medicine
- Section Editors
- Daniel F Danzl, MD
Daniel F Danzl, MD
- Section Editor — Environmental Emergencies
- Professor of Emergency Medicine
- University of Louisville School of Medicine
- Stephen J Traub, MD
Stephen J Traub, MD
- Section Editor — Toxicology
- Associate Professor of Emergency Medicine
- Mayo Medical School
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
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) .
This topic will discuss the clinical manifestations, diagnosis, and management of scombroid (histamine) poisoning. Other microbial and marine foodborne diseases are discussed separately:
●(See "Ciguatera fish poisoning".)
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