Three Geriatric Patients Presenting with Atropa Belladonna (Deadly Nightshade) Poisoning within 5 Days

Abstract

Introduction: Atropa belladonna (AB), commonly known as deadly nightshade, is known to be toxic. AB has toxic anticholinergic effects on the body. Anticholinergic toxic syndrome (ATS) affects both the central and peripheral nervous systems, causing delirium, hallucination, tachycardia, choreoathetoid movements, mydriasis, and dry skin.Case Report: The first case includes a 70-year-old man who was brought to the emergency department by his relatives with complaints of confusion, hallucinations, and meaningless conversation. The second case was related to a 75-year-old female patient brought to the emergency department with the same complaints. Upon regaining consciousness, it was learned from the history that both cases ate this plant for regulation of blood sugar. The third case was related to a 60-year-old man brought to the emergency department with complaints of agitation and confusion. All three patients underwent conservative treatment.Conclusion: It would be lifesaving to do anamneses in detail as often as clinical examination and imaging in cases that may be confused with acute cerebrovascular events. It was concluded that poisoning derived from plants, especially in geriatric patients who have consciousness, hallucination, meaningless hand gestures, and speech findings, must be considered thoroughly.

Two Patients of 113 and 77 Years Old of Atropa Belladonna Poisoning Case Report

“…Since impaired consciousness, which can be seen in geriatric poisoning cases, can be confused with acute cerebrovascular events, taking a detailed anamnesis as well as clinical examination and imaging methods will be life-saving. Especially in geriatric patients presenting with clouding of consciousness, hallucinations, meaningless body movements and speech findings, poisoning due to plants should be considered in the differential diagnosis 1 .…”

“…Bowel sounds should be checked before administration of activated charcoal because of the risk of ileus. Activated charcoal can be used for decontamination and intravenous (IV) fluid replacement should be provided 1,5,6,9 . The antidote of anticholinergic toxidromes (poisonings) is Physostigmine 10 .…”

“…As a general approach, it is used in cases where the patient's clinical condition cannot be controlled (such as hyperthermia, delirium or tachycardia) together with physostigmine, benzodiazepine administration and hydration. Physostigmine dose; It is administered as 0.5-2 mg IV (administered in 5 minutes) in adults and 20 μg / kg (0.02 mg / kg) in children 1,5,6 .…”

“…If urinary retention is detected in patients, a Foley catheter should be inserted. Rhabdomyolysis can be seen in patients and attention should be paid 1,5,6 .…”

“…Atropa Belladonna is a poisonous plant species in the solanaceae family 1 . It grows wild in our provinces such as the Black Sea Region, Kırklareli, Bolu, Balıkesir, Adana, Hatay and Osmaniye 2 .…”