Keywords: Scromboid, Histamine (PubMed Search)
Scromboid (histamine fish poisoning) can be easily misdiagnosed since its' clinical presentation can mimic that of allergy. Seen most frequently in the summer and occurring with Scombroideafish (tuna, mackerel, bonito, skipjack) but also with large dark meat fish (sardines and anchovies) and even more commonly with nonscromboid fish such as mahi mahi and amber jack. In warm conditions when fish is improperly refrigerated, bacterial histidine decarboxylase converts muscle histidine into histamine which quickly accumulates. Histamine is heat stable and not destroyed with cooking.
Scromboid poisoning is due to histamine ingestion and is often misdiagnosed as allergic reaction. It is preventable with proper fish storage.
Severe scombroid fish poisoning: an underrecognized dermatologic emergency. Jantschitsch C, Kinaciyan T, et al. J Am Acad Dermatol 2011; 65:246–7.
Histamine fish poisoning: a common but frequently misdiagnosed condition. Attaran RR, Probst F. Emerg Med J 2002;19:474–5.