Histamine Fish Toxicity - Inadequate refrigeration increases enzyme from bacteria on fish 

Clinical 

• Skin flushing, throbbing headache, abdominal cramps 

• Oral burning, nausea, diarrhea, palpitations 

• Symptoms occur within 10-30 min of eating fish 

Management 

• Supportive care 

• Antihistamines (e.g. diphenhydramine) 



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