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Case Reports in Emergency Medicine
Volume 2014, Article ID 482531, 4 pages
http://dx.doi.org/10.1155/2014/482531
Case Report

Histamine Poisoning from Ingestion of Fish or Scombroid Syndrome

1Anaesthesia and Intensive Care Unit, General Hospital “Pugliese-Ciaccio”, Viale Pio X, 88100 Catanzaro, Italy
2Emergency Medicine Unit, General Hospital “Pugliese-Ciaccio”, 88100 Catanzaro, Italy

Received 13 September 2014; Revised 18 November 2014; Accepted 18 November 2014; Published 7 December 2014

Academic Editor: William D. Grant

Copyright © 2014 Vincenzo Tortorella et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The scombroid poisoning is due to the ingestion of poorly preserved fish (especially tuna, sardines, and mackerel) out of the cold chain. Under the influence of the proliferation of gram negative bacteria that occurs for heating, the histidine content in the muscle of the fish is converted into histamine, by the action of the enzyme histidine decarboxylase. If the histamine is ingested in large quantities, it causes an anaphylactoid reaction with a variety of symptoms from moderate to severe to life-threating. We will describe two cases that came under our observation after consuming a meal of bluefin tuna. The diagnosis of scombroid syndrome was made on the basis of the anamnestic data and the clinical one. The rapid resolution of the signs and symptoms after treatment with histamines H1-H2 receptor blockers confirmed the suspected diagnosis.