Inhalation of steaming seafood aroma: sudden death in an asthmatic

A 29-year-old asthmatic with a family history of atopy inhaled a large dose of fumes from sizzling, steaming seafood being served to another client in a restaurant. She immediately developed respiratory distress, loss of consciousness and cyanosis; she also vomited profusely, aspirated and died with 58 min of the onset of symptoms. Autopsy revealed epiglottitis and tracheobronchitis associated with an infiltration by mast cells. The blood IgE was marginally elevated. Death was attributed to upper respiratory airway obstruction due to aspiration of gastric contents, and to bronchospasm following the inhalation of steaming vapour from the seafood dish. The practice of transporting a platter of sizzling, steaming seafood across dining rooms and restaurants with its aroma permeating the entire premises could prove fatal for atopic customers.