MRCP revision battle 52.7: Scromboid poisoning

Scromboid poisoning is caused by the ingestion of amines, mainly histamines, which are produced by bacterial decarboxylation of histadine in fish meat (mainly tuna, mackeral, sardines, anchoives, marlin)

The commonest cause of scromboid poisoning is ingestion of spoiled fish following improper refridgeration.  Cooking well will not inactivate the hisatmines that have been produced.

Degree of symptoms correlates to amount of fish consumed.

Symptoms include:

• nausea
• abdo pain
• diarrhoea
• flushing
• rash
• headache 
• palpitations
• hypo or hypertension

Onset of symptoms tends to be within 10 to 30 mins but may take up to 2 hours
Symptoms tend to settle within 36 hours

Treatment is with antihistamine; corticosteroids are not indicated.


People with asthma or on isoniazid may be more severely affected.