Ingestion of A Common Plant’s Leaves Leads to Acute Respiratory Arrest and Paralysis: A Case Report

Author:

Kear Breelan1,Lee Richard2,Church Sanford2,Youssef Fady3,Arguija Anthony4

Affiliation:

1. University of California, Irvine Medical Center, Department of Emergency Medicine, Orange, California

2. University of California, Irvine Medical Center, Department of Internal Medicine, Orange, California

3. Memorial Care, Long Beach Medical Center, Department of Pulmonary and Critical Care Medicine, Long Beach, California; University of California, Irvine Medical Center, Department of Pulmonary and Critical Care Medicine, Orange, California

4. Memorial Care, Long Beach Medical Center, Department of Emergency Medicine, Long Beach, California

Abstract

Background: Nicotiana glauca is a plant known to cause acute toxicity upon ingestion or dermal exposure due to the nicotinic alkaloid, anabasine. Nicotinic alkaloids cause toxicity by acting as agonists on nicotinic-type acetylcholine receptors (nAChRs). Initial stimulation of these receptors leads to symptoms such as tachycardia, miosis, and tremors. The effects of high doses of nicotinic alkaloids are biphasic, and eventual persistent depolarization of nAChRs at the neuromuscular junction occurs. This causes apnea, paralysis, and cardiovascular collapse. Case Report: In this report, we present a case of respiratory arrest due to nicotinic alkaloid poisoning from the ingestion of Nicotiana glauca. The diagnosis was suspected after the patient’s family gave a history of the patient ingesting a plant prior to arrival. They were able to also provide a physical sample of the plant. Conclusion: The phone application, “Plant Snap”, determined the plant species and helped confirm the diagnosis. This case describes how modern technology and thorough history taking can combine to provide the best possible patient care.

Publisher

Western Journal of Emergency Medicine

Subject

General Medicine

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