Digitalis-like Toxic Symptoms Occurring after Accidental Nerium indicum Poisoning.
- Author:
Ye Wan SONG
1
;
Jung Hwan AHN
;
Chung Ah LEE
;
Gi Woon KIM
;
Sang Cheon CHOI
;
Yoon Seok JUNG
Author Information
1. Emergency Department, Ajou University, School of Medicine, Suwon, Republic of Korea. avenue59@ajou.ac.kr
- Publication Type:Case Report
- Keywords:
Digitalis;
Nerium indicum;
Poisoning
- MeSH:
Adolescent;
Atrioventricular Block;
Cardiac Glycosides;
Charcoal;
Digitalis;
Digoxin;
Dizziness;
Eating;
Electrocardiography;
Emergencies;
Hematologic Tests;
Humans;
Intensive Care Units;
Korea;
Mediterranean Region;
Nausea;
Nerium;
Vital Signs;
Vomiting
- From:Journal of The Korean Society of Clinical Toxicology
2009;7(1):19-22
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Although Nerium indicum poisoning is a globally rare occurrence, Nerium oleander poisoning is known to occur frequently in the Mediterranean regions. To our knowledge, this is the first reported case of accidental Nerium indicum poisoning in Korea. Its poisoning symptoms and signs are similar to that of digitalis poisoning, because of the presence of cardiac glycosides in Nerium indicum. A 16-year-old boy was admitted to the emergency department four hours prior to the accidental ingestion of Nerium indicum petals. The patient complained of nausea, vomiting, and dizziness. His initial vital signs were stable; laboratory blood test results were within normal levels, except for the blood digoxin level (1.5 ng/dL). An electrocardiogram (ECG) analysis showed normal sinus rhythm, progressive PR prolongation and second-degree Morbiz type I AV block. Conservative treatments including activated charcoal administration were conducted, because toxic symptoms and signs were not severe. The patient was admitted to the intensive care unit for close observation. His ECG was converted to normal rhythm after 1 day and the toxic symptoms and signs were completely resolved after 4 days.
