Abstract
Introduction: Atropa belladonna (AB), commonly known as deadly nightshade, is known to be toxic. AB has toxic anticholinergic effects on the body. Anticholinergic toxic syndrome (ATS) affects both the central and peripheral nervous systems, causing delirium, hallucination, tachycardia, choreoathetoid movements, mydriasis, and dry skin.Case Report: The first case includes a 70-year-old man who was brought to the emergency department by his relatives with complaints of confusion, hallucinations, and meaningless conversation. The second case was related to a 75-year-old female patient brought to the emergency department with the same complaints. Upon regaining consciousness, it was learned from the history that both cases ate this plant for regulation of blood sugar. The third case was related to a 60-year-old man brought to the emergency department with complaints of agitation and confusion. All three patients underwent conservative treatment.Conclusion: It would be lifesaving to do anamneses in detail as often as clinical examination and imaging in cases that may be confused with acute cerebrovascular events. It was concluded that poisoning derived from plants, especially in geriatric patients who have consciousness, hallucination, meaningless hand gestures, and speech findings, must be considered thoroughly
References
- Southgate HJ, Egerton M, Dauncey EA. Lessons to be learned: a case study approach. Unseasonal severe poisoning of two adults by deadly nightside (Atropa belladonna). J R Soc Promot Health 2000; 120: 127-30. [CrossRef]
- Demirhan A, Tekelioğlu ÜY, Yıldız İ, Korkmaz T, Bilgi M, Akkaya A et al. Atropa Bellodonna Fruit (Deadly Nightshade) Related Anticholinergic Toxic Syndrome: A Case Report. Türk Anest Rean Der Dergisi 2013; 41: 226-8.
- Joshi P, Wicks AC, Munshi SK. Recurrent autumnal psychosis. Postgrad Med J 2003; 79 (930): 239-40. [CrossRef]
- Karadaş S, Selvi Y, Mustafa Ş, Selvi F, Reşit Ö, Özgekçe F. Datura Stramonium Zehirlenmesi: Psikiyatrik Belirtilerle Başvuran Olgu. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2011; 24: 152-4.
- Spina SP, Taddei A. Teenagers with Jimson weed (Datura stramonium) poisoning. CJEM 2007; 9: 467-8.
- Lange A, Toft P. Poisoning with nightside, Atropa belladona. Ugeskr Laeger 1990; 152: 1096.
- Perlik-Gattner I. Atropa belladona poisoning suggesting severe post traumatic brain damage. Przegl Lek 1997; 54: 464-5.
- Berdai MA, Labib S, Chetouani K, Harandou M. Atropa belladonna intoxication: a case report. Pan Afr Med J 2012; 11: 72.
- Schneider F, Lutun P, Kintz P, Astruc D, Flesch F, Tempe JD: Plasma and urine concentrations of atropine after the ingestion of cooked deadly nightshade berries. J Toxicol Clin Toxicol 1996; 34: 113-7. [CrossRef]
- Ceha LJ, Presperin C, Young E, Allswede M, Erickson T: Anticholinergic toxicity from nightshade berry poisoning responsive to physostigmine. J Emerg Med 1997; 15: 65–9. [CrossRef]
Three Geriatric Patients Presenting with Atropa Belladonna (Deadly Nightshade) Poisoning within 5 Days
Abstract
Giriş: Güzel avrat otu olarak bilinen Atropa belladonna (AB) zehirli
bir bitkidir. AB antikolinerjik etki ile zehirlenme yapar. Antikolinerjik
toksiksendrom (ATS), santral ve periferik sinir sistemini birlikte
etkileyerek deliryum, halüsinasyon, taşikardi, koreoatetoid
hareketler, midriyazisve kuru deri gibi bulgularla karşımıza çıkar.
Olgu Sunumu: İlk olgu; şuur bulanıklığı, halüsinasyon ve anlamsız
konuşma şikayetleri ile yakınları tarafından acil servisimize getirilen
yetmiş yaşında erkek hasta idi. İkinci olgu da aynı şikayetleri ile
acil servise getirilen yetmiş beş yaşında kadın hasta idi. Şuurları
açıldıktan sonra her iki olgunun anamnezinde kan şekerlerinin
düzenlenmesi için bu bitkiyi yedikleri öğrenildi. Üçüncü olgu
ajitasyon, anlamsız konuşma ve şuur bulanıklığı şikayetleri ile
acil servise getirilen altmış yaşında erkek hasta idi. Üç olguya da
konservatif tedavi uygulandı.
Sonuç: Bu gibi vakalar akut serebrovasküler olaylar ile
karışabileceği için klinik muayane ve görüntüleme yöntemleri
kadar detaylı anamnezalınması hayat kurtarıcı olacaktır. Özellikle
şuur bulanıklığı, halüsinasyon, anlamsız el hareketleri ve konuşma
bulguları ile gelen geriatrikhastalarda ayırıcı tanıda bitkilere bağlı
zehirlenmenin mutlaka düşünülmesi gerektiği kanısına vardık.
References
- Southgate HJ, Egerton M, Dauncey EA. Lessons to be learned: a case study approach. Unseasonal severe poisoning of two adults by deadly nightside (Atropa belladonna). J R Soc Promot Health 2000; 120: 127-30. [CrossRef]
- Demirhan A, Tekelioğlu ÜY, Yıldız İ, Korkmaz T, Bilgi M, Akkaya A et al. Atropa Bellodonna Fruit (Deadly Nightshade) Related Anticholinergic Toxic Syndrome: A Case Report. Türk Anest Rean Der Dergisi 2013; 41: 226-8.
- Joshi P, Wicks AC, Munshi SK. Recurrent autumnal psychosis. Postgrad Med J 2003; 79 (930): 239-40. [CrossRef]
- Karadaş S, Selvi Y, Mustafa Ş, Selvi F, Reşit Ö, Özgekçe F. Datura Stramonium Zehirlenmesi: Psikiyatrik Belirtilerle Başvuran Olgu. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2011; 24: 152-4.
- Spina SP, Taddei A. Teenagers with Jimson weed (Datura stramonium) poisoning. CJEM 2007; 9: 467-8.
- Lange A, Toft P. Poisoning with nightside, Atropa belladona. Ugeskr Laeger 1990; 152: 1096.
- Perlik-Gattner I. Atropa belladona poisoning suggesting severe post traumatic brain damage. Przegl Lek 1997; 54: 464-5.
- Berdai MA, Labib S, Chetouani K, Harandou M. Atropa belladonna intoxication: a case report. Pan Afr Med J 2012; 11: 72.
- Schneider F, Lutun P, Kintz P, Astruc D, Flesch F, Tempe JD: Plasma and urine concentrations of atropine after the ingestion of cooked deadly nightshade berries. J Toxicol Clin Toxicol 1996; 34: 113-7. [CrossRef]
- Ceha LJ, Presperin C, Young E, Allswede M, Erickson T: Anticholinergic toxicity from nightshade berry poisoning responsive to physostigmine. J Emerg Med 1997; 15: 65–9. [CrossRef]
Details
| Other ID | JA75GD36HR |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | May 1, 2014 |
| Submission Date | May 1, 2014 |
| Published in Issue | Year 2014 Volume: 5 Issue: 5 |