Scombroid poisoning: mini-review with case histories.

Scombroid poisoning has become an almost world-wide medical problem. It is probably the most common cause of fish poisoning, although frequently misdiagnosed as "Salmonella infection'. While there remains some question as to the definitive etiology, there is little doubt that the poisoning is caused by the ingestion of certain mackerel-like fishes whose tissues have undergone a number of changes provoked by bacteria, and involving the conversion of histidine to histamine, potentiated by diamines. Improper storage of the fishes, usually at temperatures above 20 degrees C, appears to be the most important predisposing factor. The organisms most commonly involved are Proteus sp., Clostridium sp., Escherichia sp., Salmonella sp. and Shigella sp. Twenty-five cases of scombroid poisoning are presented. The clinical manifestations were very similar in most cases, consisting of: alterations in taste; anxiety; hyperemia, particularly of the face and neck; nausea; pruritus; headache; certain other symptoms and signs. Most patients responded to antihistamitics, and all cases were self-limiting.

Stings by the sea anemone Anemonia sulcata in the Adriatic Sea.

The sea anemone Anemonia sulcata is the clinically most important Actinaria in the Adriatic Sea. Between 1965 and 1980, 55 patients stung by this cnidarian were seen at the Pula Medical Center in Istria, Yugoslavia. The majority of injuries were inflicted upon the upper extremities, chest, or abdomen. Pain and the appearance of small blanched papules surrounded by slightly reddened and edematous bases were the usually initiating manifestations. Linear lesions were sometimes seen. Vesicles, sometimes filled with serous fluid, localized discoloration, and the formation of bullae sometimes followed. Somnolence, dizziness, nausea, vomiting, muscle aches, and lid edema were reported in some cases. The treatment of these injuries in the northern Adriatic Sea and elsewhere is discussed.

Latrodectism: variations in clinical manifestations provoked by Latrodectus species of spiders.

The clinical picture caused by the bite of Latrodectus spp. is described, including the patient's general condition with agonizing pains, cramps, spasms, motor unrest, boardlike abdomen, "facies latrodectismica", sweating, oliguria, hypertension, anxiety, mental excitation and an extended convalescence. The notorious biters are mainly L. mactans, L. variolus, L. hesperus, L. tredecimguttatus, L. hasselti, L. indistinctus and L. menavodi, all of which appear to provoke somewhat similar clinical pictures. For some species, however, there is limited data and for the toxicity of some spiders, such as L. rhodesiensis, no data are available, However, it would appear that the clinical manifestations of the venom are similar in all species.

Some clinical and epidemiological problems of venom poisoning today.

Poisonings caused by bites and stings of venomous animals have not lost their importance from most ancient times until today. Rather, one could say that they in some respects have become even more important due to some moments as: the interesting results of biochemical, pharmacological and immunological researches of their venoms, so as possibilities of their use in treatment and in preparation of drugs; the importation of venomous animals in loads of goods from countries with warm climate into countries where they normally would not be found; the increasing number of fanciers who keep in their terraria often very dangerous animals; the interest of most armies of the world for venomous animals and poisonings due to them. However, the author stressed the increasing importance of venomous stings and bites from the point of view of modern tourism. The epidemiological and clinical features of poisoning by some animals in tourists are described: so for instance the consequences of bites and stings of spiders, gad flies, scolopendras, scorpions, coelenterates and fishes.

[Enteric infections by Salmonella: occurrence of positive blood cultures, positive urine cultures and high antibody titres (author's transl)]. / Uber das Vorkommen von positiven Blutkulturen, positiven Urinkulturen und hohen Antikörper-Titern bei Infektionen mit Enteritis-Salmonellen.

In the last two decades the classic typhoid and paratyphoid A and B became rare also in Istria being substituted by infections of salmonellas of the "minor group". Basing on observations on 418 patients (1970-1979) it was established that in 48.5% of them a significant increase of titers of antibodies, not only for group antigens but also for phasis antigens developed. This, together with positive hemocultures and urine cultures in a number of them, did lead the authors to the conclusion that the invasitivity of these salmonellas (e.g. S. enteritidis, typhi murium, hadar, agona, abony) is greater than previously presumed and that the diagnosis "Salmonella-Fever" or "Paratyphoid" also in infections of these salmonellas is more justified.