From the Research
Scombroid food poisoning from consuming cooked salmon typically presents with symptoms such as erythema, urticaria, facial flushing, sweating, palpitations, hot flushes, headache, nausea, vomiting, and dizziness, usually occurring within half an hour of ingestion. These symptoms are caused by the ingestion of fish that has accumulated scombrotoxin, a heat-stable toxin identified as histamine, during spoilage 1. The clinical presentation closely resembles an acute allergic reaction, which may lead to misdiagnosis.
Key symptoms of scombroid food poisoning include:
- Erythema and urticaria of the skin
- Facial flushing and sweating
- Palpitations and hot flushes of the body
- Headache
- Nausea and vomiting
- Dizziness
Treatment for scombroid food poisoning typically involves the administration of antihistamines, with major toxicity requiring aggressive management similar to acute anaphylaxis 1, 2. It is essential to recognize the syndrome as an intoxication rather than an allergic reaction to identify the source of the toxin and prevent further cases.
In severe cases, patients may require aggressive fluid resuscitation and monitoring in the emergency department 2. The diagnosis of scombroid poisoning can be confirmed by the presence of the clinical syndrome and demonstration of high histamine levels in the cooked fish 1.
Proper handling, storage, and cooking of salmon can help prevent scombroid food poisoning. Cooking salmon to an internal temperature of 145°F (63°C) can kill most harmful bacteria and parasites, but it may not eliminate the risk of scombroid poisoning since the toxin is heat-stable 1.