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Ackee Fruit Toxicity Follow-up

  • Author: Dave A Holson, MD, MBBS, MPH; Chief Editor: Timothy E Corden, MD  more...
 
Updated: Apr 23, 2015
 

Further Inpatient Care

Patients who have consumed ackee fruit and have the following conditions should be admitted to the hospital:

  • Severe and persistent hypoglycemia
  • Intractable vomiting
  • Seizures
  • Altered mental status
  • Hypotension
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Inpatient & Outpatient Medications

See the list below:

  • Administer dextrose solution to maintain normal blood glucose levels.
  • Decontamination with activated charcoal is contraindicated in patients with active emesis and risk of seizure.
  • Administer antiemetics to control vomiting.
  • Administer thiamine to the patient who is alcoholic or malnourished.
  • Administer benzodiazepines to control seizures.
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Deterrence/Prevention

See the list below:

  • Avoid eating unripe ackee fruit.
  • Avoid eating ackee fruit that has been forcibly opened.
  • Discard water in which ackee fruit is boiled.
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Complications

See the list below:

  • Profound hypoglycemia
  • Acidosis
  • Hypovolemia
  • Seizures
  • Coma
  • Death
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Prognosis

See the list below:

  • Before treatments were developed, the mortality rate was 80%.
  • Most patients have a full recovery.
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Patient Education

See the list below:

  • Educate patients about the danger of eating unripe or forcibly opened ackee fruit.
  • Instruct patients to discard the water in which the fruit was prepared.
  • Inform patients about the symptoms and signs of ackee fruit poisoning and the importance of immediately seeking medical attention.
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Contributor Information and Disclosures
Author

Dave A Holson, MD, MBBS, MPH Assistant Professor of Emergency Medicine, Mount Sinai School of Medicine; Director, Department of Emergency Medicine, Queens Hospital Center

Dave A Holson, MD, MBBS, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, National Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Received salary from Merck for employment.

Chief Editor

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

Michael E Mullins, MD Assistant Professor, Division of Emergency Medicine, Washington University in St Louis School of Medicine; Attending Physician, Emergency Department, Barnes-Jewish Hospital

Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians

Disclosure: Received stock ownership from Johnson & Johnson for none; Received stock ownership from Savient Pharmaceuticals for none.

Acknowledgements

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Glendon C Henry, MD, and Sekuleo Gathers, MD, to the original writing and development of this article.

References
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Freshly picked Ackee fruit
Black seeds surrounded by a thick, oily, yellow aril (edible portion).
 
 
 
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