Clinical Case Answer: Scombroid Poisoning The patients bedside cardiac exam showed a hyperdynamic left ventricle, no pericardial effusion and no right ventricular enlargement. The inferior vena cava was flat. The patient was quickly suspected of having scombroid poisoning. Scombroid (histamine) poisoning results from consumption of fish not kept cool during storage. Symptoms include cutaneous flushing, hives, vomiting, abdominal cramping and diarrhea. Severe cases can result in dizziness, chest tightness, bronchospasm and hypotension. The patient was treated successfully with diphenhydramine, ranitidine and 20ml/kg normal saline. Scombroid is a clinical diagnosis, does not equate to fish allergy and should be reported to public health officials when recognized.
Posted on: Sat, 24 Jan 2015 23:42:49 +0000
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