Abstract
Scombroid poisoning is the most common fish-borne–related illness that is encountered in clinical practice by clinicians. The presentation of this condition can often mimic that of fish allergies and lead to misdiagnosis and treatment. Nurse practitioners should be familiar with the presentation of scombroid poisoning, risk factors, pathophysiology, and condition management. This case challenge presents a patient presenting to the emergency department with signs and symptoms of scombroid poisoning with the nurse practitioner's diagnostic reasoning while evaluating such a patient.
•This is a clinical case presentation for facial flushing, nausea, sweating, and palpitations after eating a fish.•Scombroid poisoning is a clinical condition in which histidine from fish flesh is converted to histamine when bacteria grows due to improper refrigeration.•When fish is consumed, it causes toxicity regardless of proper cooking or freezing after the histamine has been built.•Diagnosis is usually clinical but can be supported by measuring histamine levels in the patient, and the gold standard is measuring histamine levels in the fish.•Medical management aims to diagnose appropriately, treat with histamine blockers, and prevent complications such as hypotension or bronchospasm from the excess histamine.
