Castor Bean and Jequirity Bean Poisoning Clinical Presentation
- Author: William Gluckman, DO, MBA, FACEP; Chief Editor: Timothy E Corden, MD more...
Assess the usual significant features that are associated with toxic environmental exposures. This includes the following:
Identification of substance
Time and duration of exposure
Treatment thus far
Ask the parents to bring in a sample of the bean, if it is possible. Having the exact bean greatly aids in the identification process. Knowing that beans are often known by various names, both common and scientific, is important.
Time and duration of exposure
Determine whether the child chewed or swallowed any beans.
Following ingestion of jequirity beans, a latent period of about 3 days occurs, and symptoms may persist more than 10 days later. Patient may present with nausea, vomiting, diarrhea, abdominal cramps, hematemesis, and melena. In some cases, acute renal failure and hepatotoxicity may occur.
Drowsiness and seizures have been reported after jequirity bean ingestion. If eye contact is made, the patient may report eye irritation and blindness. Skin contact may result in a rash.
Following ingestion of castor beans, the patient may become symptomatic from 8-24 hours after exposure. The clinical picture may appear very similar to jequirity bean ingestion, with GI symptoms that can progress to hypotension, liver and renal failure, and death.
Inhalation of castor bean toxin can cause illness within 8 hours. Symptoms include cough, dyspnea, arthralgias, fever, respiratory distress, and death. Injection of ricin causes symptoms within 6 hours, which may include weakness and myalgias with progression of the illness to fever, hypotension, multiorgan failure, and death.
Determine if any treatment has been administered to the child prior to presentation.
Inquire about any other potential exposures or injury.
Inquire about past medical history, medications, and allergies.
See the list below:
Assess airway patency. It is extremely uncommon to have any oral or upper airway swelling of sufficient magnitude to cause airway compromise. Breathing usually is unaffected. Circulation may become affected as shock develops, secondary to severe gastroenteritis.
Patients may develop severe cutaneous hypersensitivity or systemic allergic reactions. An urticarial, immunoglobulin E–mediated allergic reaction may occur with the development of tongue or facial swelling, bronchospasm, and acute upper airway obstruction.
See the list below:
Both castor and jequirity beans are commonly encountered as ornamental beans or seeds.
Castor and jequirity beans are commonly used as prayer beads, bracelets, or necklaces.
Castor and jequirity beans are also used as the seeds that rattle in maracas.
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