eMedicine Specialties > Emergency Medicine > Toxicology

Plant Poisoning, Castor Bean and Jequirity Bean: Treatment & Medication

Author: William Gluckman, DO, MBA, FACEP, Assistant Professor, Department of Surgery, Section of Emergency Medicine, University of Medicine and Dentistry of New Jersey, University Hospital; Attending Emergency Physician, St Joseph's Regional Medical Center; President and CEO, FastER Urgent Care
Coauthor(s): Gregory S Sugalski, MD, Staff Physician, Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey Hospital
Contributor Information and Disclosures

Updated: Nov 21, 2008

Treatment

Medical Care

  • The first priority in treating a patient with castor or jequirity bean poisoning is to establish that the patient's airway is patent and that breathing and circulation are adequate.
  • Supportive care that is based on clinical symptoms is the primary therapy. Replace GI fluid losses with intravenous fluids.
  • Whole bowel irrigation (WBI) has been suggested to ensure rapid and complete decontamination of the GI tract; however, the clinical use of WBI has not been demonstrated. In theory, rapid elimination of the bean before erosion of the outer shell may decrease or prevent the release of potent toxins. Consult the nearest regional poison control center before undertaking WBI.
  • Count beans to assure complete recovery.
  • Patients should remain under observation for at least 4-6 hours. Asymptomatic patients may be discharged safely after this period.
  • Once the patient is symptomatic, supportive care involves attention to fluid, glucose, and electrolyte replacement.

Consultations

  • Report all exposures to the regional poison control center.
  • The American Association of Poison Control Centers (AAPCC) is the only national organization currently tracking all potentially poisonous ingestions and may be helpful in bean identification.
  • Expert consultation with a trained toxicologist is also recommended and can be obtained at the regional poison control center.

Medication

Medication is not currently a component of care for this condition (see Treatment).

More on Plant Poisoning, Castor Bean and Jequirity Bean

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References
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References

  1. Audi J, Belson M, Patel M, et al. Ricin poisoning: a comprehensive review. JAMA. 2005;Nov 9;294(18):2342-51. [Medline].

  2. Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). Dec 2007;45(8):815-917. [Medline].

  3. Doan LG. Ricin: mechanism of toxicity, clinical manifestations, and vaccine development. A review. J Toxicol Clin Toxicol. 2004;42(2):201-8. [Medline].

  4. Challoner KR, McCarron MM. Castor bean intoxication. Ann Emerg Med. Oct 1990;19(10):1177-83. [Medline].

  5. Fernando C. Poisoning due to Abrus precatorius (jequirity bean). Anaesthesia. Dec 2001;56(12):1178-80. [Medline].

  6. Ferraz AC, Angelucci ME, Da Costa ML, et al. Pharmacological evaluation of ricinine, a central nervous system stimulant isolated from Ricinus communis. Pharmacol Biochem Behav. Jul 1999;63(3):367-75. [Medline].

  7. Kinamore PA, Jaeger RW, de Castro FJ. Abrus and ricinus ingestion: management of three cases. Clin Toxicol. Oct 1980;17(3):401-5. [Medline].

  8. Krenzelok EP, Jacobsen TD. Plant exposures ... a national profile of the most common plant genera. Vet Hum Toxicol. Aug 1997;39(4):248-9. [Medline].

  9. Navarro-Rouimi R, Charpin D. Anaphylactic reaction to castor bean seeds. Allergy. Oct 1999;54(10):1117. [Medline].

  10. Olsnes S. The history of ricin, abrin and related toxins. Toxicon. 2004;Sep 15;44(4):361-70. [Medline].

  11. Palatnick W, Tenenbein M. Hepatotoxicity from castor bean ingestion in a child. J Toxicol Clin Toxicol. 2000;38(1):67-9. [Medline].

  12. Rauber A. Plantlore revisited. J Toxicol Clin Toxicol. 1999;37(4):521-4. [Medline].

  13. Schwenk M, Kluge S, Jaroni H. Toxicological aspects of preparedness and aftercare for chemical-incidents. Toxicology. 2005;214(3):232-48. [Medline].

  14. Spivak L, Hendrickson RG. Ricin. Crit Care Clin. 2005;Oct;21(4):815-24, viii. [Medline].

  15. Vitetta ES, Smallshaw JE, Coleman E, et al. A pilot clinical trial of a recombinant ricin vaccine in normal humans. Proc Natl Acad Sci USA. 2006;103(7):2268-73. [Medline].

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Further Reading

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Keywords

castor bean, caster bean plant, caster bean seeds, caster bean poison, jequirity bean,  terrorism, ricin, gastroenteritis

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Contributor Information and Disclosures

Author

William Gluckman, DO, MBA, FACEP, Assistant Professor, Department of Surgery, Section of Emergency Medicine, University of Medicine and Dentistry of New Jersey, University Hospital; Attending Emergency Physician, St Joseph's Regional Medical Center; President and CEO, FastER Urgent Care
William Gluckman, DO, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Gregory S Sugalski, MD, Staff Physician, Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey Hospital
Gregory S Sugalski, MD is a member of the following medical societies: American Medical Association and Emergency Medicine Residents Association
Disclosure: Nothing to disclose.

Medical Editor

Michael E Mullins, MD, Assistant Professor, Department of Emergency Medicine, Washington University School of Medicine
Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology and American College of Emergency Physicians
Disclosure: Johnson & Johnson stock ownership None; Savient Pharmaceuticals stock ownership None

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Jeffrey R Tucker, MD, Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut and Connecticut Children's Medical Center
Jeffrey R Tucker, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Pediatrics, and Massachusetts Medical Society
Disclosure: Merck Salary Employment

CME Editor

Paul D Petry, DO, FACOP, FAAP, Consulting Staff, Freeman Pediatric Care, Freeman Health System
Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association
Disclosure: Nothing to disclose.

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, and Wisconsin Medical Society
Disclosure: Nothing to disclose.

 
 
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