1/24. Toad venom poisoning: resemblance to digoxin toxicity and therapeutic implications.A healthy man developed gastrointestinal symptoms after ingesting purported aphrodisiac pills. He had severe unrelenting bradycardia, hyperkalaemia, and acidosis. He rapidly developed severe life threatening cardiac arrhythmias and died after a few hours. He was found to have positive serum digoxin concentrations, although he was not taking digoxin. Toad venom poisoning is similar to digitalis toxicity and carries a high mortality. Cardiac glycoside poisoning can occur from ingestion of various plants and animal toxins, and the venom gland of cane toad (bufo marinus) contains large quantities of cardiac glycosides. Toad venom, a constituent of an aphrodisiac, was considered responsible for the development of clinical manifestations and death in this patient. digoxin specific Fab fragment has been reported to be beneficial in the treatment of toad venom poisoning. This report alerts physicians to the need to be aware of a new community toxic exposure, as prompt treatment with digoxin specific Fab fragment may be life saving. The treatment approach to patients with suspected toad venom poisoning is described.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
2/24. Gloriosa superba poisoning.Suicidal attempts by consuming poisonous extracts of a creeper plant Gloriosa superba are frequent in this region. An instance of such poisoning is reported here, wherein a family engaged in business dealing with this plant consumed the crude liquid extract of its root. The symptoms were mainly gastrointestinal. The children had more severe symptoms which included sweating, hypotension, jaundice, bradycardia and convulsions. The features were reversible with symptomatic treatment alone.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
3/24. Acute poisoning with autumn crocus (colchicum autumnale L.).INTRODUCTION: colchicum autumnale, commonly known as the autumn crocus or meadow saffron, contains the antimitotic colchicine, which binds to tubulin and prevents it forming microtubules that are part of the cytoskeleton in all cells. CASE REPORT: A 71-year-old woman ate a plant she thought to be wild garlic (allium ursinum). Ten hours later she arrived at the emergency department complaining of nausea, vomiting and watery diarrhea. Ingestion of a poisonous plant was suspected and she was treated with gastric lavage, oral activated charcoal and an infusion of normal saline. toxicology analysis with gas chromatography and mass spectrometry revealed colchicine in the patient's gastric lavage, blood (5 microg/l) and urine (30 microg/l). She developed arrhythmias, liver failure, pancreatitis, ileus, and bone marrow suppression with pancytopenia. alopecia began in the third week. Treatment was supportive only. Five months later she had no clinical or laboratory signs of poisoning. DISCUSSION: The patient mistakenly ingested autumn crocus instead of wild garlic because of their great similarity. colchicine primarily blocks mitosis in tissues with rapid cell turnover; this results in gastroenterocolitis in the first phase of colchicine poisoning, bone marrow hypoplasia with pancytopenia in the second and alopecia in the third, all of which were present in our patient. colchicine toxicity in tissues without rapid cell turnover caused arrhythmias, acute liver failure and pancreatitis. CONCLUSION: colchicine poisoning can result in gastroenterocolitis followed by multi-organ dysfunction syndrome. In unexplained gastroenterocolitis after ingestion of wild plants as a salad or spice, especially when wild garlic is mentioned, we should always consider autumn crocus. diagnosis could be confirmed only by toxicology analyses. Management of colchicine poisoning is restricted to supportive therapy.- - - - - - - - - - ranking = 6keywords = gas (Clic here for more details about this article) |
4/24. datura delirium.Poisoning with tropine alkaloids from cultivated plants and pharmaceuticals is an uncommon cause of delirium and coma. We report a patient with a toxic delirium following ingestion of the tropine alkaloid-containing root of datura innoxia. Thin-layer chromatography and gas chromatography/mass spectrometry confirmed the presence of atropine and scopolamine in samples of the ingested root. Routine clinical toxin screens may not include an assay for tropine alkaloids. A specific tropine alkaloid assay may provide supporting evidence. The clinical, electroencephalographic, and therapeutic aspects of anticholinergic poisoning are discussed.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
5/24. ajuga nipponensis Makino poisoning.A 58-year-old man ingested an herbal preparation of ajuga nipponesis Makino, as recommended in folk medicine for the treatment of hepatoma. He developed profound gastrointestinal upset immediately, and decreasing urine output and bilateral leg edema over the following 2 days. Notable laboratory findings included elevated levels of blood urea nitrogen, creatine, bilirubin, and hepatic transaminases. Deterioration of renal function was noted during hospitalization and he died 11 days after ingesting the herbal preparation. Two other healthy individuals also consumed the same herbal preparation at the same time but developed only vomiting and diarrhea. One or more of the four major components of ajuga nipponesis Makino may be responsible for the renal toxicity found in our patient.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
6/24. Jimson weed toxicity: management of anticholinergic plant ingestion.Jimson weed is a hallucinogenic plant that is common in rural areas. Consumption of any part of the plant can result in severe anticholinergic toxicity. The clinical presentation of jimson weed toxicity is similar to that seen in cases of atropine poisoning. Treatment is aimed at removing plant material from the gastrointestinal tract, keeping the patient safe and reversing severe anticholinergic sequelae.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
7/24. anticholinergic syndrome due to 'Devil's herb': when risks come from the ancient time.We describe a case of mandragora autumnalis poisoning which occurred in a 72-year-old female patient who had eaten the venenous M. Autumnalis, picked near her home, mistaking it for the edible borago Officinalis. M. Autumnalis is a solanaceous plant, common in the Sicilian countryside, which contains a variable concentration of solanum alkaloids, causing gastrointestinal irritation, and tropane alkaloids, with anticholinergic properties. Unluckily, M. Autumnalis is often mistaken for the edible B. Officinalis, likewise widespread in Sicilian countryside. The diagnosis of mandragora poisoning was made on the basis of clinical symptoms and signs of anticholinergic syndrome associated with a history of vegetable meal of uncontrolled origin, moreover analysing the vegetable obtained from gastric lavage. decontamination and symptomatic treatment were useful in our patient to control acute poisoning.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
8/24. castor bean intoxication.We report the cases of a child who ingested two or more castor beans and two adults who each ingested four beans. All three patients developed severe gastroenteritis and recovered without sequelae after receiving IV fluids. The literature contains reports of 424 cases of castor bean intoxication. Symptoms of intoxication include acute gastroenteritis, fluid and electrolyte depletion, gastrointestinal bleeding, hemolysis, and hypoglycemia. Delayed cytotoxicity has not been reported. Of the 424 patients, 14 died (mortality rates: 8.1% of untreated and 0.4% of treated). Deaths were due to hypovolemic shock. Recommended treatment for asymptomatic patients who have chewed one or more raw beans is emergency department evaluation, gastric decontamination, administration of activated charcoal, observation until four to six hours after ingestion, and discharge instructions to return if symptoms develop. After decontamination and activated charcoal, symptomatic patients require hospitalization for treatment with IV fluids, supportive care, and monitoring for hypoglycemia, hemolysis, and complications of hypovolemia. Monitoring for delayed cytotoxicity is unnecessary. Castor beans and their dust are highly allergenic and may cause anaphylaxis.- - - - - - - - - - ranking = 4keywords = gas (Clic here for more details about this article) |
9/24. A fatal poisoning from Nicotiana glauca.A young adult male was found dead in a field. No cause of death was apparent at autopsy, and the only positive toxicological finding was the presence of a nicotine-like alkaloid isolated from the liver. anabasine, the major, highly toxic alkaloid of the shrub, Nicotiana glauca (tree tobacco) was subsequently identified in all body specimens examined using gas chromatography/mass spectrometry. Concentrations of anabasine in blood, urine and other body organs are reported.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
10/24. hemlock water dropwort poisoning.Severe plant poisoning is relatively uncommon in adults. We report two adults who ingested hemlock water dropwort roots, having mistaken them for wild parsnip. One developed prolonged convulsions, severe metabolic acidosis and respiratory distress requiring mechanical ventilation. The toxin--oenanthotoxin--was detected in the gastric aspirate and measured by high performance liquid chromatography.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
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