VizD Answer 3/24/2007

Congratulations to Nurse Kelly , she was the first person to submit the correct answer to this week's VizD.

To view Nurse Kelly's answer, click here and go to the comments link.

Nurse Kelly is the winner of $10.

Recap:
A 37-year-old man presents to your ED complaining of a throbbing headache, diarrhea, and rash. Neurologic examination is unremarkable. He just finished eating dinner at a Japanese restaurant.
Questions (click on image to enlarge)
1. What is the name of this disorder?
2. Name 3 etiologies of this disorder?
3.What is the treatment of choice for this disorder?

Answers:
1. Scombroid fish poisoning
2. Typically associated with the consumption of fish
-tuna
-mackerel
-mahi-mahi
-amber jack
-rudder fish
-oil fish
3. Antihistamines H1 & H2 (diphenhydramine, ranitidine)

For a review on the topic, check out the article "Scombroid" in Annals of Emergency Medicine 1996; 28(2) 235-238

Abstract
Scombroid poisoning is described in the literature as a toxic poisoning caused by ingestion of certain dark meat fish undergoing bacterial decomposition. Poisoning results from the ingestion of a heat-stable toxin. We describe the case of a man who presented to the emergency department several hours after eating tuna steak with evidence of scombroid poisoning that was associated with loss of vision and atrial tachycardia with block. All signs and symptoms resolved after treatment for scombroid poisoning.

The next VizD will be posted on Monday April 9th

VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.