Case report: a rare case of attempted homicide with Gloriosa superba seeds.

BACKGROUND: Gloriosa superba, well known as the glory lily or superb lily, is a tropical climbing plant that features an exotic red flower. The plant is poisonous because of high concentrations of colchicine in all parts of the plant. It is commercially grown for use in Ayurveda medicine and as a cash crop for extracting colchicine in India and Africa. It is a wild plant in Sri Lanka and commercial cultivation is rare. Accidental and suicidal poisonings with Gloriosa tubers are well known and reported. There are no case reports of poisoning by Gloriosa seeds in Sri Lanka. Google and PubMed searches showed no reported cases of poisoning with seeds or their use with homicidal intent in other parts of the world. CASE PRESENTATION: A 27-year-old man was brought to hospital with profuse vomiting and diarrhea after drinking coriander tea, which is a common traditional treatment for common cold. The family members suspected poisoning by Gloriosa because they had seeds at home and the victim's sister-in-law who had made the herbal tea went missing from home. They were able to identify Gloriosa seeds, which looked similar to coriander, in the pot. The patient developed shock and respiratory distress and needed ventilation and intensive care. He also developed mild renal impairment, and thrombocytopenia. He developed massive generalized alopecia while recovering from acute illness. Full recovery was achieved after 15 days of hospital care. CONCLUSIONS: There are many poisonous plants in Asian countries. This case highlights the possibility of accidental or intentional use of Gloriosa seeds or its extracts to cause potentially fatal poisoning. It would be difficult to identify Gloriosa as the cause of poisoning without any background information because of multiple complications that can mimic a systemic infection. This case is a good example of the use of plants as biological weapons.

Anticholinergic syndrome and supraventricular tachycardia caused by lavender tea toxicity.

Lavender plants have been used for their cosmetic and biologic benefits for many centries. Extracts from Lavandula plants have been found to cause antimuscarinic effects by blocking sodium and calcium ion channels in in vitro and in vivo studies. We present a case of poisoning by ingestion of tea made from Lavender stoechas ( grass). The patient was admitted to our emergency department with supraventricular tachycardia due to anticholinergic syndrome triggered by drinking lavender tea. On electrocardiography, a narrow QRS complex tachycardia was evident. After carotid sinus massage, the patient immediately returned to sinus rhythm. There are no reported data about the toxicity of Lavender stoechas plants with respect to supraventricular tachycardia, anticholinergic syndrome or sympathetic nerve activity.

Skeletal fluorosis due to excessive tea and toothpaste consumption.

We describe the case of a 53-year-old woman who presented with a metatarsal fracture and was found to have a bone mineral density (BMD) T-score of +11 in the lumbar spine and +7.6 in the hip. Subsequent investigation revealed very high serum, urine and tissue fluoride levels, associated with excessive tea and toothpaste consumption. The case emphasises the need to exclude fluorosis in individuals with unexpectedly high BMD levels.

[Accidental drowning due to tropane alkaloid abuse]. / Ertrinkungsunfall bei Tropanalkaloidbeeinflussung.

The cause of drowning deaths in good swimmers may be difficult to solve. After homicide, suicide and other kinds of immersion deaths have been ruled out, not only alcohol and narcotics, but also other psychotropic substances such as thornapple and angel's trumpet should be taken into consideration--at least in adolescents and young adults. The article reports on an accidental death by drowning under the influence of tropane alkaloids after consumption of a decoction of the flowers of angel's trumpet.

[A case of datura stramonium poisoning--general problems of differential diagnosis]. / Csattanómaszlag-mérgezés esete--a differenciáldiagnózis gyakorlati kérdései.

In past year drug abuse becomes more and more general in Hungary. In addition to consume traditional drugs, other substances are used frequently too. One of them is the Datura stramonium, which contains alkaloids (mostly atropine), and can result in hallucinations. Therefore Datura stramonium is seemingly becoming popular as a hallucinogenic drug. The consumption of any part of the plant causes atropine intoxication, thus anticholinergic delirium. Differential diagnosis of Datura intoxication can be difficult in the everyday medical practise. In our paper the symptomatology, diagnosis, differential diagnosis, and therapy of Datura intoxication are discussed and we report one of our cases.

Severe rhabdomyolysis following massive ingestion of oolong tea: caffeine intoxication with coexisting hyponatremia.

A 36-y-o patient with schizophrenia, who had consumed gradually increasing quantities of oolong tea that eventually reached 15 L each day, became delirious and was admitted to a psychiatric hospital. After abstinence from oolong tea his delirium resolved. He was transferred to our hospital when he was discovered to have acute renal failure with hyponatremia (118 mEq/L) and severe rhabdomyolysis (creatine phosphokinase, 227,200 IU/L). On admission rhabdomyolysis had begun to improve despite a worsening of the hyponatremia (113 mEq/L). With aggressive supportive therapy, including hypertonic saline administration and hemodialysis, the patient fully recovered without detectable sequelae. The clinical course suggests that caffeine, which is present in oolong tea, was mainly responsible for the rhabdomyolysis as well as the delirium, although severe hyponatremia has been reported to cause rhabdomyolysis on rare occasions. We hypothesize that caffeine toxicity injured the muscle cells, which were fragile due to the potassium depletion induced by the coexisting hyponatremia, to result in unusually severe rhabdomyolysis. The possibility of severe rhabdomyolysis should be considered in a patient with water intoxication due to massive ingestion of caffeine-containing beverages.

[Scopolica carniolica Jacq. tea]. / Hexentee.

We report a case of plant-poisoning of a young man following the consumption of a self-brewed infusion made of a solanaceous plant, to which he was seduced by his friends. He developed anticholinergic symptoms such as optical hallucinations, confusion, mydriasis and tachycardia. 14 hours after admission the patient was discharged from hospital in good health. With regard to this case we portray the mentioned plant (Scopolica carniolica Jacq.) and discuss the symptoms of belladonna-alkaloid-poisoning and its therapy. Further on, in a short literature survey, we depict the meaning of collective drug experiences with plants containing atropine-like substances in ancient and modern times.