J Korean Soc Clin Toxicol.  2009 Jun;7(1):19-22.

Digitalis-like Toxic Symptoms Occurring after Accidental Nerium indicum Poisoning

Affiliations
  • 1Emergency Department, Ajou University, School of Medicine, Suwon, Republic of Korea. avenue59@ajou.ac.kr

Abstract

Although Nerium indicum poisoning is a globally rare occurrence, Nerium oleander poisoning is known to occur frequently in the Mediterranean regions. To our knowledge, this is the first reported case of accidental Nerium indicum poisoning in Korea. Its poisoning symptoms and signs are similar to that of digitalis poisoning, because of the presence of cardiac glycosides in Nerium indicum. A 16-year-old boy was admitted to the emergency department four hours prior to the accidental ingestion of Nerium indicum petals. The patient complained of nausea, vomiting, and dizziness. His initial vital signs were stable; laboratory blood test results were within normal levels, except for the blood digoxin level (1.5 ng/dL). An electrocardiogram (ECG) analysis showed normal sinus rhythm, progressive PR prolongation and second-degree Morbiz type I AV block. Conservative treatments including activated charcoal administration were conducted, because toxic symptoms and signs were not severe. The patient was admitted to the intensive care unit for close observation. His ECG was converted to normal rhythm after 1 day and the toxic symptoms and signs were completely resolved after 4 days.

Keyword

Digitalis; Nerium indicum; Poisoning

MeSH Terms

Adolescent
Atrioventricular Block
Cardiac Glycosides
Charcoal
Digitalis
Digoxin
Dizziness
Eating
Electrocardiography
Emergencies
Hematologic Tests
Humans
Intensive Care Units
Korea
Mediterranean Region
Nausea
Nerium
Vital Signs
Vomiting
Cardiac Glycosides
Charcoal
Digoxin
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