What condition did a 39-year-old man develop after eating mahi mahi, characterized by abdominal cramps and trouble breathing?

The condition that developed in the 39-year-old man after consuming mahi mahi, characterized by abdominal cramps and trouble breathing, is best understood as scombroid fish poisoning. This condition occurs due to the consumption of certain types of fish that have been improperly stored or processed, leading to the production of toxins, specifically histamine. Mahi mahi, being a member of the larger fish family that can be affected this way, is known for this risk.

When these fish are not kept at the proper temperature, bacteria convert the fish's natural histidine into histamine, which can cause symptoms similar to an allergic reaction. The symptoms can include gastrointestinal issues—like abdominal cramps—and respiratory problems—such as trouble breathing—due to the body’s reaction to the excess histamine.

In contrast, a food allergy is typically characterized by an immune response triggered by specific proteins in the food, leading to a range of symptoms that can include hives, swelling, or anaphylaxis, but these do not align perfectly with the symptoms experienced in this scenario.

Shellfish allergy specifically pertains to reactions from mollusks and crustaceans and is not applicable here since mahi mahi is not part of this group. Fish intolerance often involves digestive issues without the immunological component associated