Gelsemium elegans Poisoning: A Case with 8 Months of Follow-up and Review of the Literature

Abstract

BackgroundGelsemium elegans (G. elegans) is a toxic plant indigenous to Southeast Asia. It is highly poisonous due to its strong respiratory depressive effect. However, G. elegans poisoning cases have not been summarized comprehensively and are rarely reported in English journals. Furthermore, none of the present reports present prognosis in detail.Case presentationA 26-year-old female was found comatose at home and brought to the hospital with deep coma, hypoxia, and acidosis. After mechanical ventilation for hours, the patient recovered from coma with sequelae of impaired short-term memory, disorientation, and childish behaviors. Brain magnetic resonance imaging (MRI) showed bilateral hippocampus and basal ganglia damage due to hypoxia. During 8 months of follow-up, both her symptoms and brain MRI scan improved significantly.ConclusionG. elegans is highly toxic. Although patients may die within 30 min due to its strong respiratory depressive effect, they can survive with timely respiratory support and enjoy gradual improvement without delayed postanoxic encephalopathy.

Clinical manifestations and causes of gelsemium poisoning in Hong Kong from 2005 to 2017: Review of 33 cases

“…Although G. elegans is extremely poisonous, it is seldom reported in the English literature. 9 This is by far the largest a This is the only severe case presented with coma, shortness of breath and respiratory depression requiring intubation and ventilatory support. b The time of symptom onset was not recorded in these two patients, and they are excluded in the calculation of symptom onset time.…”

“…8 Although G. elegans poisoning is quite commonly found in the Chinese literature, large case series are seldom reported in English journals. 9 The objective of this study is to present the local situation of gelsemium poisoning in Hong Kong over the past decades since the establishment of Hong Kong Poison Information Centre (HKPIC) and to evaluate the clinical manifestation and causes.…”

Poisoning by toxic plants in Hong Kong: a 15-year review

“…Gelsemium elegans is one of the most notorious poisonous plants in Hong Kong and South-East Asian countries and has been used for homicidal and suicidal purposes. 31,32 Severe gelsemium toxicity can result in respiratory depression and even death. In our case series, two clusters of "hidden" gelsemium poisoning were identified where the patients consumed non-toxic parasitic Cassytha filiformis which absorbed gelsemium alkaloids from Gelsemium elegans on which it grew.…”

Gene expression profile analysis of ileum transcriptomes in pigs fed Gelsemium elegans plants

“…However, Gelsemium elegans , a poisonous plant, exerts obvious toxicity toward the human body. Poisoning has often been reported after people have eaten Gelsemium elegans by mistake 3 . After poisoning, patients suffer from symptoms such as dizziness, sweating, nausea, vomiting, muscle relaxation, limb paralysis, dyspnea, coma and convulsion 4,5 .…”