History provides clues to a patient's food allergy

A patient's meticulous history leads to the diagnosis of a condition that may be more common than originally thought

Belinda, a normally well 45-year-old self-employed private caterer, presents with infrequent episodes of severe vomiting followed by diarrhoea and feeling profoundly unwell for the next 24 hours.

After sleuthing on the internet, she suspects that she may be allergic to squid and octopus.

She takes no medications, drinks socially and does not smoke. She gets localized reactions to bee stings and had an urticarial rash following penicillin as a child.

There is no personal or family history of atopy.