Scombroid poisoning is a common reason for admission to the emergency room. In ordinary clinical practice, distinguishing between scombroid syndrome and seafood allergy might be challenging. The goal of this review is to give the doctor some tools to help them establish an accurate differential diagnosis. In recent years, there has been a greater understanding of scombroid syndrome, particularly in terms of its potentially severe manifestations. Two cases of Kounis syndrome subsequent to scombroid syndrome have been documented, and a differential diagnosis in individuals with this clinical presentation might be even more challenging in these situations. Finally, in terms of diagnosis, serum tryptase has recently been validated.

Scombroid syndrome is a histamine-induced reaction caused by eating histamine-contaminated fish, whereas fish allergy is an IgE-mediated response. Because clinical manifestations might be similar, scombroid syndrome is frequently misdiagnosed. The distinctions are seen in pathogenic processes, potential outcomes, therapy, and preventative strategies. Furthermore, several laboratory testing can assist in distinguishing between the two illnesses.