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[One Case for Two].

Ilaria Jermini-Gianinazzi¹, Marco Jermini², Marcello Di Valentino³

¹1 Notfallstation, Ospedale Regionale di Bellinzona e Valli, Bellinzona.

|May 2, 2019

Summary

This summary is machine-generated.

Scombroid fish poisoning, a histamine-related reaction, mimicked anaphylaxis in a patient experiencing rash, hypotension, and chest pain after tuna consumption. Prompt food safety investigation is crucial for preventing further cases.

Keywords:

Histamin Kounis syndrome Kounis-Syndrom Réaction scombroïde Scombroid syndrome Scombroid-Syndrom anaphylactic shock anaphylaktischer Schock histamine réaction anaphylactique syndrome de Kounis

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Area of Science:

Allergy and Immunology
Toxicology
Food Safety

Background:

Scombroid fish poisoning is a non-allergic hypersensitivity reaction.
It results from consuming fish with high histamine levels, often from the Scombridae family.
Symptoms can mimic allergic reactions, including rash and hypotension.

Observation:

A 59-year-old patient presented with rash, hypotension, and chest pain post-tuna consumption.
The clinical presentation suggested a severe reaction to contaminated fish.
Kounis syndrome, a vasospastic acute coronary syndrome, is a rare manifestation of anaphylaxis.

Findings:

The patient was diagnosed with scombroid fish poisoning.
This diagnosis was based on the characteristic symptoms following ingestion of scombrid fish.
The case highlights the potential overlap in presentation between scombroid poisoning and anaphylaxis.

Implications:

Immediate notification of food safety authorities is essential for investigation and prevention.
Public health measures are needed to ensure fish safety and prevent histamine contamination.
Clinicians should consider scombroid poisoning in patients with allergic-like symptoms after fish consumption, especially when coronary symptoms are present.