Datura intoxication in an adolescent male: A challenge in the Internet era

Abstract

A 14-year-old, previously well, adolescent male was brought to the emergency department of a regional hospital in Australia by his father shortly after midnight. The boy was in a state of delirium and displayed visual hallucinations and disinhibited behaviour. His father revealed that the boy had been playing soccer in the park that afternoon with his brother and friends. He had complained of a headache when he returned home in the evening and went to bed after taking paracetamol. At around 2100 hours, his father found him confused with incoherent speech trying to climb the walls. His father described him as a normally reserved and responsible boy with no previous history of drug or alcohol abuse.In the emergency department, the boy was playing with imaginary objects (a ball, trying to pick things off the floor), and he kept wandering into other patient's cubicles and the staff base. He was uncoordinated and unable to follow commands. His physical examination revealed Glasgow Coma Scale (GCS) of 13, tachycardia with heart rate of 115/min and bilateral dilated sluggish pupils of 9 mm. Abdominal examination revealed a palpable urinary bladder, and a bladder scan confirmed urinary retention (urine volume of 560 mL) (Fig. 2). His full blood count, blood sugar, electrolytes and liver function tests were all unremarkable, and a urine drug screen was negative. He required 3 mg of diazepam to settle. The features of anticholinergic toxicity were recognised; however, a clear cause was unable to be ascertained at the time.The following morning, the boy had normal mental status with GCS of 15. However, he had no recall of the events the evening prior and the reason for his presentation to the emergency department. He had persisting bilateral dilated sluggish pupils of 8 mm and reported blurred vision. Upon further questioning, he revealed that he had intentionally eaten the seeds of a plant he found growing by the river (subsequently confirmed to be a Datura plant, most likely Datura inoxia) on a 'dare' by his friends (Fig 1a,b). He also divulged that his friends had seen a 'YouTube' video of Datura ingestion and its effects, which had prompted them to dare him. He denied having experimented with the plant previously and denied any drug or alcohol abuse.He was observed in the paediatric ward without any further symptoms or complications and discharged after 24 h. He was reviewed again by the paediatric team 4 days later, and his examination was completely normal, with normal mentation and normal pupillary size and reactivity. He was counselled about risktaking behaviour and its consequences.

Keracunan Tanaman Kecubung

“…2020 intoksikasi Datura stramonium selama periode 1998-2004, paling banyak pada laki-laki (81,8%) dan pada rentang usia 13-19 tahun (72,2%). 5 Gejala klinis Gejala utama keracunan tanaman kecubung adalah gejala parasimpatis yang meningkat seperti midriasis atau dilatasi pupil akibat hambatan muskulus spinkter papilaris, mulut kering akibat hambatan sekresi saliva, takikardia akibat kompetisi reseptor muskarinik di neuron parasimpatis postganglion, serta hambatan pada reseptor nodus Sinus Atrial (SA), demam, dan eritema akibat vasodilatasi dan inhibisi kelenjar keringat. 2,6 Atropin dan skopolamin dapat menyerang susunan saraf pusat (SSP) menimbulkan gejala delirium, halusinasi, agitasi, ataupun eksitasi.…”

“…9 Terdapat beberapa laporan penelitian bahwa kemudahan internet membuat risiko penyalahgunaan tanaman Datura stramonium ini berkembang. 5,10 Kemudahan informasi melalui internet membuat tanaman ini juga dapat mudah diperoleh. 5,10 Selain itu, informasi khasiat tanaman ini mudah diperoleh melalui internet tanpa melihat potensi efek sampingnya.…”

“…5,10 Kemudahan informasi melalui internet membuat tanaman ini juga dapat mudah diperoleh. 5,10 Selain itu, informasi khasiat tanaman ini mudah diperoleh melalui internet tanpa melihat potensi efek sampingnya. 5,10 Verrier, dkk.…”

“…5,10 Selain itu, informasi khasiat tanaman ini mudah diperoleh melalui internet tanpa melihat potensi efek sampingnya. 5,10 Verrier, dkk. 10 melaporkan terdapat 16 situs internet yang merekomendasikan konsumsi tanaman ini untuk berbagai penggunaan dan informasi efek psikotropikanya.…”