A Fishy Tale

Author: Fiona Mendes / Editor: Martin Dore / Reviewer: Fiona Mendes / Codes: / Published: 18/06/2022

Whilst visiting from abroad, an elderly couple named Ariel and Sebastian stay at a luxurious hotel in the city and visit a nearby exclusive new restaurant for their dinner. Ariel has freshly prepared sushi sprinkled with sesame seeds. Sebastian eats a tuna steak.

During their evening stroll, approximately twenty minutes after paying and leaving the restaurant, Sebastian suddenly develops a pruritic erythematous rash and is brought to the nearest Emergency Department where you are called to see him.

His face and neck have confluent erythema with blotches on his upper and lower limbs.

He is speaking in full sentences. He does not have stridor, wheeze or shortness of breath. On auscultation, his chest is clear with equal air entry. He is haemodynamically normal.

He has no known allergies and has eaten fish before. He was previously well and does not take any medication.

You diagnose scombrotoxic fish poisoning and start the initial treatments.

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