Abstract

Scombroid poisoning (SP) is one of the most common causes of morbidity associated with fish consumption. The condition is caused by elevated levels of histamine in dark-fleshed fish and fish products due to inadequate processing or storage temperatures. This multicenter study was conducted at four hospitals located in two major coastal cities in Türkiye: İstanbul and Trabzon. Patient records were retrospectively evaluated for 108 cases from January 1, 2014, to December 31, 2023. A total of 79 patients were included in the study. Demographics, clinical findings, and discharge outcomes are reported. The onset of complaints was 0-60 minutes in 72 cases (91.1%) and over 1 hour in 7 cases (8.9%). Most patients were admitted to the Emergency Departments in groups of three (36.7%), four (32.9%), and two (20.3%). The most common symptom was skin rash, observed in 78 SP cases (98.7%), followed by abdominal pain in 65 (82.3%), headache in 59 (74.7%), dizziness in 54 (68.4%), heartburn in 47 (59.5%), metallic taste in the mouth in 38 (48.1%), circumoral paresthesias in 34 (43%), nausea/vomiting in 20 (25.3%), and palpitations in 13 (16.5%) patients. This study emphasizes the importance of initial diagnosis based on symptoms and patient history. With accurate diagnosis and antihistamine treatment, the benefits are significant in terms of cost-effectiveness, quality of care, hospital crowding, and patient satisfaction. The significance is discussed from a broad perspective, spanning the disciplines of emergency medicine and public health. The practical clinical suggestions apply to cases on the rise worldwide.

Key words: Histamine fish poisoning, food safety, emergency medicine, public health