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Plant Poisoning, Hemlock: Differential Diagnoses & Workup
Updated: Nov 7, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Other Problems to Be Considered
Botulism
Nicotine (wild tobacco)
Golden chain (Laburnum anagyroides)
Strychnine
Cholinergic poisoning
Psychosis
Encephalopathy
Workup
Laboratory Studies
- Consider the following tests if patient is hemodynamically unstable or has altered mental status or seizures:
- Basic metabolic profile including electrolytes, glucose, BUN, and creatinine
- Arterial blood gas
- Comprehensive drug screen to evaluate for co-ingestions
- Creatine kinase or urine myoglobin to screen for rhabdomyolysis
- Consider a pregnancy test for women of childbearing age.
Imaging Studies
- Perform chest radiographs if aspiration is suspected.
Other Tests
- Chemical screening test for alkaloids in plant material provides confirmation of toxicity due to poison or water hemlock. However, a plant specimen (or ingested material) is required, and these tests are not routinely available.
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Differential Diagnoses & Workup: Plant Poisoning, Hemlock |
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References
Uwai K, Ohashi K, Takaya Y. Exploring the structural basis of neurotoxicity in C(17)-polyacetylenes isolated from water hemlock. J Med Chem. Nov 16 2000;43(23):4508-15. [Medline].
Watson WA, Litovitz TL, Klein-Schwartz W, et al. 2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 2004;22(5):335-404. [Medline].
Ellenhorn MJ. Poison hemlock (Conium Maculatum). In: Ellenhorn's Medical Toxicology. 2nd ed. Williams and Wilkins; 1997:1841, 1871.
Furbee B, Wermuth M. Life-threatening plant poisoning. Crit Care Clin. Oct 1997;13(4):849-88. [Medline].
Goldfrank LR, Flomenbaum NE, Lewin NA, et al, eds. Goldfrank's Toxicologic Emergencies. 6th ed. Appleton & Lange; 1998:2, 318, 338, 1246, 1252-3.
Hopkins J. The glycoalkaloids: naturally of interest (but a hot potato?). Food Chem Toxicol. Apr 1995;33(4):323-8. [Medline].
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].
Litovitz TL, Klein-Schwartz W, Caravati EM. 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].
Litovitz TL, Klein-Schwartz W, Dyer KS. 1997 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 1998;16(5):443-97. [Medline].
Litovitz TL, Klein-Schwartz W, White S. 1999 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 2000;18(5):517-74. [Medline].
Lopez TA, Cid MS, Bianchini ML. Biochemistry of hemlock (Conium maculatum L.) alkaloids and their acute and chronic toxicity in livestock. A review. Toxicon. Jun 1999;37(6):841-65. [Medline].
Olson KR. Hemlock. In: Poisoning and Drug Overdose. 3rd ed. Appleton & Lange; 1999:22, 25, 30, 265-74.
Panter KE, James LF, Gardner DR. Lupines, poison-hemlock and Nicotiana spp: toxicity and teratogenicity in livestock. J Nat Toxins. Feb 1999;8(1):117-34. [Medline].
Reynolds T. Hemlock alkaloids from Socrates to poison aloes. Phytochemistry. 2005;66(12):1399-1406. [Medline].
Vetter J. Poison hemlock (Conium maculatum L.). Food Chem Toxicol. Sep 2004;42(9):1373-82. [Medline].
Watson WA, Litovitz TL, Rodgers GC, et al. 2002 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 2003;21(5):353-421. [Medline].
Further Reading
Keywords
hemlock, plant poison hemlock, poison hemlock, Conium maculatum, C maculatum, water hemlock, Cicuta maculata, C maculata, plant ingestion, Queen Anne's lace, wild carrot, fool's parsley
Differential Diagnoses & Workup: Plant Poisoning, Hemlock