J Korean Soc Clin Toxicol.  2019 Dec;17(2):132-134. 10.22537/jksct.2019.17.2.132.

A Case of Green Tobacco Sickness (GTS) in Elderly Patient

• Jeong DK
• Kim DE

• KMID: 2470197
• DOI: http://doi.org/10.22537/jksct.2019.17.2.132

Abstract

Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.

Keyword

Green tobacco sickness; Nicotine; Poisoning

MeSH Terms

Aged*
Angiography
Blood Pressure
Brain
Chills
Colic
Cotinine
Dizziness
Emergency Service, Hospital
Female
Half-Life
Headache
Humans
Magnetic Resonance Imaging
Nausea
Nicotine
Poisoning
Rain
Respiration
Salivation
Sweat
Sweating
Tobacco*
Vomiting
Weather
Cotinine
Nicotine