1/6. Rare jatropha multifida intoxication in two children.Two children were admitted to the Emergency Department (ED) after ingesting a large amount of fruit of a plant identified as jatropha multifida. They were mildly obtunded, had intractable vomiting, and seemed dehydrated. Intravenous fluid replacement and urine alkalinization were initiated. After stabilization, their 5-day hospital stays were uneventful except for a subclinical rise of liver enzymes. jatropha species contain the toxalbumin ricin, which causes severe vomiting and diarrhea, dehydration, shock, and renal and hepatic impairment. Ricin also has cardiotoxic and hemolytic effects and several deaths have been documented. Children are attracted by the shape and the color of the jatropha fruits. mortality can be prevented by immediate fluid and electrolyte replacement.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
2/6. 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 = 1keywords = shock (Clic here for more details about this article) |
3/6. Toxic shock syndrome associated with poison oak dermatitis.Toxic shock syndrome commonly occurs in menstruating women, but it is known to be associated with a variety of staphylococcal infections. We report a case of nonmenstrual toxic shock syndrome in an 11-year-old male who presented with altered consciousness and infected poison oak dermatitis of the feet. This is the first reported case of toxic shock syndrome associated with poison oak dermatitis. The signs and symptoms, laboratory findings, and treatment of toxic shock syndrome are reviewed.- - - - - - - - - - ranking = 76.152521530753keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
4/6. Fatal cardiac arrhythmias and shock following yew leaves ingestion.A 40-year-old woman presented with vomiting and abdominal pain following voluntary ingestion of 150 yew leaves. She developed ventricular conduction defects and arrhythmias unresponsive to medical treatment after admission. She expired five hours after yew ingestion from irreversible cardiogenic shock. More attention should be given to this rare but severe intoxication for which no effective therapy is known.- - - - - - - - - - ranking = 5keywords = shock (Clic here for more details about this article) |
5/6. castor bean poisoning.Although the highly toxic nature of castor bean (ricinus communis) is well recognized, reports of human toxicity in the English medical literature are scarce. The potentially lethal doses reported for children and adults are three beans and four to eight beans respectively. Recent experience with two cases provides added insight into the expected course of toxicity. In both cases, repeated vomiting, diarrhea, and transiently elevated serum creatinine occurred. dehydration was much more pronounced in the second case. Both patients recovered uneventfully. Other reported manifestations of castor bean toxicity, such as hepatic necrosis, renal failure, erythrocyte hemolysis, convulsions, and shock, did not occur.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
6/6. Confirmation of oleander poisoning by HPLC/MS.A non-fatal case of nerium oleander (common oleander) self-poisoning in a 45-year-old female is presented. Initial symptoms were nausea and vomiting, abdominal pain, phosphenes, cardiovascular shock and sinus brady-cardia. blood and urine were assayed for oleandrin, the major cardiac glycoside of N. oleander, using a highly specific HPLC/MS procedure. The blood concentration of oleandrin at admission was 1.1 ng/ml. This is the first report of an oleander intoxication ascertained by the mass spectrometric identification of oleandrin in blood. HPLC/MS appears to be the method of choice for the forensic-toxicological investigation of poisonings by cardiac glycosides.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |