Scombrotoxism: A case series from the French Poison Control Centre Network from 2012 to 2021

Scombroid Fish poisoning is observed after ingestion of fish mainly of the scom-bridae family. The flesh of usually edible fish such as tuna or mackerel can, under certain conditions, contain significant amounts of histamine generating a clinical picture which evokes anaphylaxis. The authors present the experience of the French Poison Control Centers over a decade (from 2012 to 2021 inclusive) concerning this frequent but often unrecognized poi-soning: 173 meals concerning 543 patients were studied (47% individual poisonings and 53% collective poisonings ranging from 2 to 200 patients per meal). There is no real seasonality with cases observed throughout the year. The coastal French departments and Southern France seem more concerned, but the whole territory including overseas territories can be the scene of this type of poisoning. If the scombridea family is involved in the vast majority of cases (93% of meals and 95% of patients), it is possible to observe such poisonings with other fish families (7 toxic meals after ingestion of fish from the clupeidae family in the present case series). The cli-nical picture is characterized by a short time to onset, symptoms mimicking an allergy and good efficacy of antihistamine drugs. For only 3 out of 543 patients, a sign of severity (cardiovascular collapse) was reported. All the patients quickly recovered without sequelae, confirming that Scombroid Fish Poisoning is an intoxication with an impressive clinical picture, but without real management problem if the diagnosis is correctly made.(c) 2022 Societe Francaise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.