title: A case of histamine fish poisoning in a young atopic woman.
abstract: Histamine fish poisoning, also known as scombroid poisoning, is a histamine toxicity syndrome that results from eating specific types of spoiled fish. Although typically a benign syndrome, characterized by self-limited flushing, headache, and gastrointestinal symptoms, we describe a case unique in its severity and as a precipitant of an asthma exacerbation. A 25-year-old woman presented to the emergency department (ED) with one hour of tongue and face swelling, an erythematous pruritic rash, and dyspnea with wheezing after consuming a tuna sandwich. She developed abdominal pain, diarrhea and hypotension in the ED requiring admission to the hospital. A diagnosis of histamine fish poisoning was made and the patient was treated supportively and discharged within 24 hours, but was readmitted within 3 hours due to an asthma exacerbation. Her course was complicated by recurrent admissions for asthma exacerbations.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, AB, Canada. Ben.wilson@albertahealthservices.ca
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Wilson
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Musto
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
mesh_terms: D000328:Adult; D000818:Animals; D001249:Asthma / Q000209:etiology; D005260:Female; D005506:Food Contamination; D005517:Foodborne Diseases / Q000175:diagnosis / Q000209:etiology*; D006632:Histamine / Q000506:poisoning*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications*; D008387:Marine Toxins / Q000506:poisoning; D017747:Seafood / Q000506:poisoning*; D014413:Tuna
chemical_list: D008387:Marine Toxins; C034101:scombrotoxin; D006632:Histamine