Castor Bean and Jequirity Bean Poisoning Treatment & Management

  • Author: William Gluckman, DO, MBA, FACEP; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Apr 19, 2011
 

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.
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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.
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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;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 American College of Physician Executives

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.

Specialty Editor Board

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 and American College of Emergency Physicians

Disclosure: Johnson & Johnson stock ownership None; Savient Pharmaceuticals stock ownership None

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: Merck Salary Employment

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.

Additional Contributors

The authors would like to thank John Kashani, DO, FACEP, for his review and comments.

References

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Castor bush.
Castor beans.
Jequirity bush.
Jequirity beans.
 
 
 
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