Scombroid Poisoning from Canned Tuna Ingestion

Abstract

Fish allergy is well recognized, however scombroid poisoning or histamine fish poisoning, which exhibits identical clinical manifestations, is rarely diagnosed. We report the case of a 28-year-old female who, after eating tuna spaghetti, experienced a flushed face, generalized erythema, angioedema, shock and tachypnea requiring adrenaline, chlorpheniramine, ranitidine, and hydrocortisone injections. Her symptoms completely resolved within
3 hours. Her condition was diagnosed as scombroid poisoning based on temporality, normal serum tryptase levels (2.7 ng/mL) at 2.5 hours and at her baseline (2.5 ng/mL, 60 hours), as well as negative results on skin-prick test and re-challenging one can of the same branded-tuna orally. The revelant public health authorities were notified and a restaurant-visit was made, although the tuna can from which the patient’s dish was prepared had been discarded,
hence a histamine analysis of the tuna was unavailable. This case underscores the need for awareness of scombroid poisoning and public interventions regarding food safety.