Hypoglycemic Plant Poisoning Clinical Presentation

Updated: Feb 18, 2019
  • Author: Nathan Reisman, MD; Chief Editor: Sage W Wiener, MD  more...
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Presentation

History

Typically, ackee fruit poisoning causes epidemics, with multiple children becoming ill. The patient may provide a history of ingesting unripe ackee fruit or water in which unripe ackee had been cooked. More than one family member may be ill.

Sudden onset of vomiting begins 2-6 hours after ingestion with generalized epigastric discomfort. However, symptoms may appear within minutes.

After a period of prostration lasting up to 18 hours, a second bout of vomiting may occur. Unless treatment is given, this episode can progress to seizures, coma, and death. In severe poisoning, death usually occurs within 12 hours after ingestion.

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Physical Examination

Nausea and vomiting occur in 75% of patients; severe vomiting may be followed by a quiescent phase, followed by recurrent vomiting. Diaphoresis and pallor may be observed. Tachypnea, tachycardia, and hypotension due to dehydration may be noted. Weakness and paresthesias may be present.  Seizures, generalized tonic clonic, occur in 24% of patients.  Drowsiness and coma occurs in 25% of patients. Mortality in severe, untreated cases can reach 80%.

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