Which combination of symptoms is characteristic of scrombroid toxicity?

• A. Labial edema, urticaria, oral burning, nausea/vomiting
• B. Cough, wheeze, chest tightness, fever
• C. Abdominal cramps, diarrhea, dehydration, dizziness
• D. Jaundice, dark urine, pale stools, fatigue

Answer: (A)

Scrombroid toxicity is caused by histamine buildup in fish that has been improperly stored, leading to a rapid, histamine-mediated reaction after eating the fish. The most telling presentation includes skin and mucosal signs along with gastrointestinal symptoms. Lip swelling (labial edema) and hives (urticaria) reflect cutaneous histamine effects, while a burning sensation in the mouth and nausea or vomiting show GI involvement. This combination—facial or lip swelling, hives, oral burning, plus GI upset—fits the pattern of histamine poisoning from spoiled fish, and histamine is not destroyed by cooking, so symptoms can occur even if the fish was cooked.

Other symptom clusters align less well with scrombroid poisoning. Respiratory symptoms with fever suggest an infectious or allergic reaction rather than histamine poisoning from spoiled fish. Abdominal cramps with diarrhea and dehydration describe GI irritation but lack the characteristic skin/hive component. Jaundice and dark urine point to liver or biliary disease rather than histamine toxicity.