Intoxicación por Datura stramonium: serie de tres casos / Datura stramonium poisoning: series of three cases

Se presenta una serie de tres casos de pacientes menores de edad con intoxicación por ingesta de semillas de Datura stramonium, ocurridos durante el mes de mayo en la provincia de Mendoza. Pacientes de sexo masculino, ente 15 y 3 años de edad. Uno de ellos asociado con ingesta intencional de semillas y otros dos por intoxicación accidental al ingerir las semillas jugando con el fruto de la planta. La recolección de semillas se realizó en zona rural periurbana, y todos los casos fueron llevados a la consulta por familiares directos, ante la presencia de desorientación, ataxia y disartria. Los tres pacientes desarrollaron síndrome anticolinérgico, con delirio y alucinaciones, requiriendo internación y tratamiento sintomático, con buena evolución y recuperación completa entre las 24 y 72 horas. Se resalta el riesgo que representa la presencia de este vegetal tóxico, no sólo por su fácil disponibilidad, sino por las bajas dosis letales de sus alcaloides y la falta de diagnóstico etiológico por parte de los servicios de urgencia.

A series of three cases of pediatric patients with poisoning by ingestion of seeds of Datura stramonium, which occurred during the month of May in the province of Mendoza is presented. Male patients, among 15 and 3 years old. One associated with intentional ingestion of seeds and other two by accidentally ingesting seeds while playing with the fruit of the poisonous plant. Seed collection was conducted in rural and peri-urban areas, and all patients were brought to the office by relatives, due to the presence of dysarthria disorientation and ataxia. The three patients developed anticholinergic syndrome with delirium and hallucinations, requiring hospitalization and symptomatic treatment. All cases had favorable outcome and complete recovery within 24 to 72 hours. It is highlighted the risk posed by the presence of this toxic plant, not only for its easy availability, but low lethal doses of its alkaloids and lack of etiological diagnosis by emergency services.

Intoxicaciones por plantas tóxicas atendidas desde un servicio de información toxicológica / Cases of poisoning caused by toxic plants seen at a toxicological information service

En muchos países la exposición accidental o voluntaria a sustancias tóxicas es causa frecuente de procesos patológicos agudos y crónicos, que constituyen la segunda causa de muerte, después de las enfermedades infecciosas. En reportes estadísticos predominan las intoxicaciones por psicofármacos y plaguicidas, pero existen otras como las provocadas por sustancias vegetales que también son consultas frecuentes en los servicios de urgencias...

In many countries, the accidental or intentional exposure to toxic substances is the frequent cause of acute and chronic pathological processes that represent the second cause of death after the infectious illnesses. In statistical reports, poisoning from pscyho drugs and herbicides prevail, but there are others as those caused by vegetable substances that are also commonly treated in the emergency services...

An outbreak of acute toxicity caused by eating food contaminated with datura stramonium

The authors report methods used to characterize an outbreak of food-borne acute toxicity among the labour force of a cotton plantation in Middle Awash Agricultural Development Enterprise in July and August 1984. Among 1492 patients seen at the Enterprise and Ministry of Health clinics during this period; 688 (46.1 per cent) exhibited unusual signs and symptoms. Thirty three patients required hospitalization for intensive medical care while nine patients were reported to have died due to this condition.Contamination of corn flour with pesticides was initially suspected and laboratory animal tests were carried out which failed to show any signs of acute toxicity. Investigation of the source of the corn and its processing was simultaneously conducted and revealed the contamination of the corn with seeds of an indigenous plant identified as Datura stramonium; an antimuscarinic alkaloid. These alkaloids contain hyoscine and hyoscyamine which is known to have toxic effect on the exocrine glands; heart; and the autonomic nervous system in man. Signs and symptoms observed in the patients and preventive measures implemented are discussed