RESUMO
We report a double lethal coconut crab Birgus latro L. poisoning in New Caledonia. Both patients died after showing gastro-intestinal symptoms, major bradycardia with marked low blood pressure, and finally asystolia. Both had significative hyperkaliemia, suggesting a digitaline-like substance intoxication. Traditional knowledge in the Loyalty Islands relates coconut crab toxicity to the consumption of the Cerbera manghas fruit by the crustacean. Elsewhere previous descriptions of human poisoning with the kernel of fruits of trees belonging to the genus Cerbera, known to contain cardiotoxic cardenolides, appear to be very similar to our cases. Cardenolides assays were performed on patient's serum samples, fruit kernel and on the crustacean guts, which lead us to suppose these two fatal cases were the result of a neriifolin intoxication, this toxin having been transmitted through the coconut crab.
Assuntos
Anomuros/química , Apocynaceae/intoxicação , Cardenolídeos/intoxicação , Cardiotoxinas/intoxicação , Frutas/intoxicação , Intoxicação por Frutos do Mar , Adulto , Idoso , Animais , Apocynaceae/química , Bradicardia/sangue , Bradicardia/etiologia , Cardenolídeos/análise , Cardenolídeos/sangue , Evolução Fatal , Frutas/química , Trato Gastrointestinal/química , Parada Cardíaca/sangue , Parada Cardíaca/etiologia , Humanos , Hiperpotassemia/sangue , Hiperpotassemia/etiologia , Hipotensão/sangue , Hipotensão/etiologia , Masculino , Nova Caledônia , Plantas Tóxicas/químicaRESUMO
The purpose of this report is to describe a case of severe systemic envenomation with cardiac arrest following a sting by the stonefish Synanceia verrucosa. Although the exact mechanism underlying cardiac arrest is debatable, cardiovascular toxicity of stonefish venom appears to have been involved. This case supports the life-threatening potential of this type of accident, a much-debated topic in recent years.
