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Scombroid is one of the most common seafood poisonings. A classic EM board question. - Caused by ingestion of histamine in fish muscle - Naturally occurring histidine is converted to histamine by bacteria in unrefrigerated fish - Most common fish: tuna, mackerel, bonito, mahi mahi, blue fish and yellow tail - Symptoms: Within minutes to hours - flushing, urticaria, perioral burning, N/V/D - Treatment: Antihistamines, fluids, bronchodilators. Epinephrine and steroid for severe reactions.