Scombroid poisoning: a traveller's tale

Natalie SY Lee and Susan C Chu
Med J Aust 2023; 218 (9): 394-394. || doi: 10.5694/mja2.51924
Published online: 15 May 2023

A 23‐year‐old previously well Australian woman with no known allergies developed an erythematous, non‐pruritic and non‐tender rash while in Bali. The rash appeared on the face and ears ten minutes after ingesting a tuna steak, spreading to the neck, chest, back and upper limbs within 20 minutes (Figure, A and B). This was associated with conjunctival injection, headache, tachycardia and light‐headedness. The patient's mother, a general practitioner, made a clinical diagnosis of scombroid poisoning1,2 and immediately administered an oral antihistamine. The rash and symptoms resolved after four hours, and the restaurant was notified. Scombroid poisoning may occur after the consumption of fish, such as tuna, salmon, mackerel, sardines and anchovies, that have been improperly refrigerated. Patients should be advised to avoid ingesting fish, particularly species with dark flesh, that have not been adequately stored.


  • Natalie SY Lee1,2
  • Susan C Chu3

  • 1 University of New South Wales, Sydney, NSW
  • 2 Royal North Shore Hospital, Sydney, NSW
  • 3 University of Sydney, Sydney, NSW


Open access

Open access publishing facilitated by University of New South Wales, as part of the Wiley ‐ University of New South Wales agreement via the Council of Australian University Librarians.

Competing interests:

No relevant disclosures.

  • 1. Predy G, Honish L, Hohn W, Jones S. Was it something she ate? Case report and discussion of scombroid poisoning. CMAJ 2003; 168: 587‐588.
  • 2. Smart DR. Scombroid poisoning. A report of seven cases involving the Western Australian salmon, Arripis truttaceus. Med J Aust 1992; 157: 748‐751.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.