Nicotine poisoning from an asparagus look-alike

This report, from the University of Wisconsin in Madison, describes two patients who developed symptoms consistent with nicotinic poisoning after ingesting foraged B australis. Patient 1 was an 85-year-old woman developed nausea, vomiting, diarrhea, abdominal distress, and dizziness within 15 minutes of ingesting what she took to be “wild asparagus.” Patient 2, her 48-year-old daughter, developed similar symptoms plus vertigo within a similar time frame after ingestion. Each patient was described as having severe truncal ataxia and was not able to stand unassisted. The patients were treated with fluids, antiemetics, meclizine, and lorazepam, admitted overnight and discharge the next morning. A sample of the “wild asparagus” was identified as B australis by the University’s Department of Horticulture. The authors speculate that the ataxia seen in both patients could be mediated by recently-discovered nicotinic receptors in the cerebellum. In their review of nicotinic plant poisoning, Schep et al point out that presentation tends to be biphasic. Characteristic manifestations of the early phase include nausea, vomiting abdominal pain, dizziness, headache, ataxia, and tremors. Later features can include diarrhea, lethargy, coma, muscle weakness and paralysis. To read my Emergency Medicine News column describing my own brush with nicotine toxicity, click here.
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical asparagus baptisia look alike nicotine toxicity Source Type: news