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Plant Poisoning, Resins: Differential Diagnoses & Workup

Author: Hagop A Isnar, MD, FACEP, Associate Medical Director, Consulting Staff, Department of Emergency Medicine, Auburn Memorial Hospital
Coauthor(s): Charles McKay, MD, Chief, Toxicology Section, Department of Traumatology and Emergency Medicine, Hartford Hospital
Contributor Information and Disclosures

Updated: Mar 2, 2009

Differential Diagnoses

Alcohol and Substance Abuse Evaluation
Plant Poisoning, Oxalates
Dermatitis, Atopic
Plant Poisoning, Phytophototoxins
Dermatitis, Contact
Toxicity, Anticholinergic
Dermatitis, Exfoliative
Toxicity, Organophosphate and Carbamate
Erythema Multiforme
Gastroenteritis
Plant Poisoning, Herbs

Other Problems to Be Considered

Plant poisoning
Essential (volatile) oils (irritants)

Workup

Laboratory Studies

  • Laboratory studies have little use in the treatment of any patient with acute plant poisoning; however, the studies may be helpful in attempts to exclude other causes of a patient's presentational signs and symptoms.
  • Evaluate any alteration in mental status with a rapid glucose determination, assessment of oxygenation status, and investigation of other potential causes such as trauma or infection.
  • Other studies, such as electrolyte determination, renal and hepatic function tests, and urinalysis, may be useful in certain situations but rarely alter treatment of exposure to a known toxic plant.
  • Obtaining a serum acetaminophen concentration is recommended for any suicidal ingestion. In absence of significant signs or symptoms, a urine drug screen rarely is useful clinically.

Other Tests

  • Electrocardiogram (ECG) and rapid potassium determination are indicated when bradycardia and/or hypotension are present.

More on Plant Poisoning, Resins

Overview: Plant Poisoning, Resins
Differential Diagnoses & Workup: Plant Poisoning, Resins
Treatment & Medication: Plant Poisoning, Resins
Follow-up: Plant Poisoning, Resins
Multimedia: Plant Poisoning, Resins
References
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References

  1. 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].

  2. Watson WA, Litovitz TL, Rodgers GC. 2004 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 2005;23(5):589-666. [Medline].

  3. Arena J. Plants That Poison. Emerg Med. Jun 15 1989;20-64.

  4. Braitberg G, et al. Toxic plant ingestions. In: Wilderness Medicine. 1995:862-89.

  5. Brodell RT, Williams L. Taking the itch out of poison ivy. Are you prescribing the right medication?. Postgrad Med. Jul 1999;106(1):69-70. [Medline].

  6. Brook I, Frazier EH, Yeager JK. Microbiology of infected poison ivy dermatitis. Br J Dermatol. May 2000;142(5):943-6. [Medline].

  7. DiPalma JR. Poisonous plants. Am Fam Physician. Apr 1984;29(4):252-4. [Medline].

  8. Evans FJ, Schmidt RJ. Plants and plant products that induce contact dermatitis. Planta Med. Apr 1980;38(4):289-316. [Medline].

  9. Geehr E. Common toxic plant ingestions. Emerg Med Clin North Am. Aug 1984;2(3):553-62. [Medline].

  10. Guin JD. Treatment of toxicodendron dermatitis (poison ivy and poison oak). Skin Therapy Lett. Apr 2001;6(7):3-5. [Medline].

  11. Hardin JW, Arena J. Human Poisonings from Native and Cultivated Plants. 1974:23, 93, 100, 107.

  12. Kunkel DB, Spoerke DG. Evaluating exposures to plants. Emerg Med Clin North Am. Feb 1984;2(1):133-44. [Medline].

  13. Lampe KF, McCann MA. AMA Handbook of Poisonous and Injurious Plants. 1985:56, 68, 115.

  14. Lee NP, Arriola ER. Poison ivy, oak, and sumac dermatitis. West J Med. Nov-Dec 1999;171(5-6):354-5. [Medline].

  15. Litovitz TL, Klein-Schwartz W, Caravati EM, et al. 1998 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 1999;17(5):435-87. [Medline].

  16. Litovitz TL, Smilkstein M, Felberg L, et al. 1996 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 1997;15(5):447-500. [Medline].

  17. McGovern TW, LaWarre SR, Brunette C. Is it, or isn't it? Poison ivy look-a-likes. Am J Contact Dermat. Jun 2000;11(2):104-10. [Medline].

  18. McKenzie RA, ALIA. Plant poisoning? Which plant?!. Aust Vet J. Jun 1993;70(6):201-2. [Medline].

  19. Patterson SE, Williams JV, Marks JG Jr. Prevention of sodium lauryl sulfate irritant contact dermatitis by Pro- Q aerosol foam skin protectant. J Am Acad Dermatol. May 1999;40(5 Pt 1):783-5. [Medline].

  20. Rondeau ES, Everson GW, Savage W, Rondeau JH. Plant nurseries: a reliable resource for plant identification?. Vet Hum Toxicol. Dec 1992;34(6):544-6. [Medline].

  21. Tilton BR, Ryan ME, Edson LY, Martyak GG. Plant ingestions in children. Pa Med. May 1985;88(5):45-9. [Medline].

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Further Reading

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Keywords

plant poisoning resins, resins, plant resins, poison ivy, poison oak, poison sumac, contact dermatitis, glycoresins, oleoresins, urushiols, poisonous plants, poisonous plant exposures, plant toxin, Toxicodendron species, Cicuta maculata, water hemlock, cicutoxin, chinaberry, Melia azedarach, tetranortriterpene, daphne, daphnetoxin, toxic plant ingestion, resin skin exposure

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Contributor Information and Disclosures

Author

Hagop A Isnar, MD, FACEP, Associate Medical Director, Consulting Staff, Department of Emergency Medicine, Auburn Memorial Hospital
Hagop A Isnar, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Charles McKay, MD, Chief, Toxicology Section, Department of Traumatology and Emergency Medicine, Hartford Hospital
Charles McKay, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, and American College of Medical Toxicology
Disclosure: Nothing to disclose.

Medical Editor

Miguel C Fernandez, MD, FAAEM, FACEP, FACMT, Associate Clinical Professor; Medical and Managing Director, South Texas Poison Center, Department of Surgery/Emergency Medicine and Toxicology, University of Texas Health Science Center at San Antonio
Miguel C Fernandez, MD, FAAEM, FACEP, FACMT is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, Society for Academic Emergency Medicine, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

Michael Hodgman, MD, Assistant Clinical Professor of Medicine, Department of Emergency Medicine, Bassett Healthcare
Michael Hodgman, MD is a member of the following medical societies: American College of Medical Toxicology, American College of Physicians, Medical Society of the State of New York, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
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