Scrombrotoxin

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Scrombrotoxin

Scrombrotoxin, also known as scombroid poisoning, is a type of foodborne illness that results from the consumption of certain types of fish that have not been properly stored. The toxin is produced by the bacterial breakdown of fish flesh, leading to the accumulation of histamine and other biogenic amines.

Causes

Scrombrotoxin poisoning typically occurs after eating fish that are part of the Scombridae family, such as tuna, mackerel, and bonito. However, it can also occur with other fish species like mahi-mahi, bluefish, and sardines. Improper storage, particularly at temperatures above 4°C (40°F), allows bacteria to proliferate and convert histidine in the fish muscle to histamine.

Symptoms

Symptoms of scrombrotoxin poisoning usually appear within minutes to a few hours after ingestion and can include:

These symptoms are often mistaken for an allergic reaction due to their similarity.

Diagnosis

Diagnosis of scrombrotoxin poisoning is primarily based on the patient's history of recent fish consumption and the rapid onset of symptoms. Laboratory tests can detect elevated levels of histamine in the consumed fish, confirming the diagnosis.

Treatment

Treatment for scrombrotoxin poisoning is generally supportive. Antihistamines such as diphenhydramine or ranitidine can be used to alleviate symptoms. In severe cases, patients may require intravenous fluids and other supportive measures.

Prevention

Preventing scrombrotoxin poisoning involves proper handling and storage of fish. Fish should be kept at temperatures below 4°C (40°F) from the time of capture until it is cooked or consumed. Additionally, consumers should be aware of the signs of spoilage in fish, such as unusual odor or texture.

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Contributors: Prab R. Tumpati, MD