Scombroid poisoning: a traveller's tale

Abstract

A 23-year-old previously well Australian woman with no known allergies developed an erythematous, non-pruritic and non-tender rash while in Bali. The rash appeared on the face and ears ten minutes after ingesting a tuna steak, spreading to the neck, chest, back and upper limbs within 20 minutes (Figure, A and B). This was associated with conjunctival injection, headache, tachycardia and light-headedness. The patient's mother, a general practitioner, made a clinical diagnosis of scombroid poisoning1, 2 and immediately administered an oral antihistamine. The rash and symptoms resolved after four hours, and the restaurant was notified. Scombroid poisoning may occur after the consumption of fish, such as tuna, salmon, mackerel, sardines and anchovies, that have been improperly refrigerated. Patients should be advised to avoid ingesting fish, particularly species with dark flesh, that have not been adequately stored. Open access publishing facilitated by University of New South Wales, as part of the Wiley - University of New South Wales agreement via the Council of Australian University Librarians. No relevant disclosures.