Monday, November 9, 2009

Dinner 1

How well do you know your toxins? This week involves toxins of a specific kind.

An hour after eating the dinner shown above, you feel flushing, warmth, and palpitations. You note an erythematous rash on the upper torso and face. You take your pulse and it is 115. Within 12 hours, the symptoms have resolved. The culprit is shown below:
Challenge: What is your diagnosis?

First image shown under GNU Free Documentation License. Second image is in the public domain.


Suheil said...

Scombroid poisoning? usually found in fishes of the scombroidae family like tuna, mahi mahi, swordfish etc.. caused due to bacterial contamination of food by organisms like halophilic vibrio, klebsiella etc which decarboxylate the histidine present in these fishes and form histamine.. which is why the reaction to these toxins mimics anaphylaxis, however, unlike anaphylaxis (where there is a propogated inflammatory reaction causing a mast cell degranulation and further histamine release) the histamine is limited and gets metabolised hence resulting in termination of the reaction.. drugs like isoniazid inhibit histamine metabolism and may put the patient at greater risk of the reaction and may prolong the symptoms.. no treatment is required unless bronchospasm occurs in which case epinephrine may be used.. condition is self limiting...

Suheil said...

the compound shown is histamine i'm assuming..

tree said...

scombroid food poisoning (histamine)

Craig Chen said...

wow! crazy! i only heard about this disease a couple weeks ago and i totally thought it was made up. i had to google it to convince myself it was real.
Dinner 1

This is scombroid, a disease classically following consumption of Scombroidae finfish (tuna (shown in the image), mackerel, skip-jack, bonito) but may be seen with other fish. It is due to bacterial overgrowth of improperly stored fish (above 20 degrees C) leading to decarboxylation of histidine into histamine (shown in second image). Histamine causes the symptoms and is not broken down by cooking, freezing, or subsequent refrigeration.

Sources: UpToDate; Wikipedia.