SCOMBROID

• Etiology: histamine intoxication due to bacterial decomposition of inadequately preserved or refrigerated scombroid fish (e.g., tuna, mackerel, saury, needlefish, wahoo, skipjack, and bonito)

– This syndrome can also occur with nonscombroid fish (e.g., sardines, herring, dolphinfish, amberjack, and bluefish).

– Affected fish typically have a sharply metallic or peppery taste but may be normal in appearance and flavor.

– Because of uneven distribution of decay within the fish, not all people who eat an affected fish will become ill.

• Clinical Features: Within 15–90 min of ingestion, pts present with flushing (exacerbated by ultraviolet exposure), pruritus, urticaria, angioneurotic edema, bronchospasm, GI symptoms, and hypotension.

– Symptoms generally resolve within 8–12 h.

– May be worse in pts concurrently taking isoniazid because of inhibition of GI tract histamine.

HOMEOPATHIC MANAGEMENT: -

Apis mel

Arsenic album

Natrum mur

Sulphur.