Ackee Fruit Toxicity Treatment & Management

Updated: Mar 28, 2022
  • Author: Dave A Holson, MD, MBBS, MPH; Chief Editor: Stephen L Thornton, MD  more...
  • Print

Approach Considerations

Traditionally, care in ackee fruit poisoning has been focused on relieving symptoms and providing supportive care with restoration of fluid, electrolyte, glucose, and pH balance. Patients with the following signs and symptoms should be admitted to the hospital:

  • Severe and persistent hypoglycemia
  • Intractable vomiting
  • Seizures
  • Altered mental status
  • Hypotension

Consultation with a medical toxicologist through the local Poison Control Center is needed.


Medical Care

Administer a bolus of hypertonic dextrose solution followed by an infusion of 10% dextrose solution. Resuscitate volume-depleted patients with dextrose in normal saline.

Administer activated charcoal, which absorbs 100-1000 mg of poison per gram of carbon, if the patient presents within 4 hours of ingestion. If mental status is altered, consideration should be given to airway protection prior to charcoal use. Decontamination with activated charcoal is contraindicated in patients with active emesis and risk of seizure.

Manage vomiting with antiemetics and seizures with benzodiazepines. Patients sometime require endotracheal intubation and ventilatory support. Administer thiamine to the patient who is alcoholic or malnourished.

Animal studies have shown that early glucose infusion with methylene blue reduces mortality associated with unripe ackee ingestion. Further testing in humans is needed. [15]