PP042 ANGELIC TRUMPET, DEVIL’S BREATH

Abstract

JMH Hng¹, AZ Zahedi²

¹Hospital Sultanah Aminah Johor Bahru, Johor, Malaysia

²University of Malaya, Kuala Lumpur, Malaysia.

Introduction:

Believes and myths often cloud the rightful mind when it comes to the use of Traditional Chinese Medicine (TCM) in Malaysia. TCM is regarded as a form complementary medicine and its widespread misconception of being safe because of their natural origins, has gained trust from public, notably in Chinese population.

Case report:

We reported a case where a 33 year-old Chinese man patient presented to the Emergency Department who developed anticholinergic poisoning after ingesting brews of Datura metel obtained from a local chinese herbal shop for diarrhea. His prominent clinical features included confusion, agitation, tachycardia, flushing, dilated pupils and dry lips. The patient had a spontaneous recovery within 48 hours with supportive measures in the intensive care unit, and no sequelae noted.

Discussion and conclusion:

Datura metel (Yangjinghua) is also known as ‘Devil’s Trumpet’, which is under the family of Solanaceae. It is a domesticated, night scented plant, which occurs naturally in both the new and ancient world. Datura metel is cultivated as a source of tropane alkaloid and scopolamine. Therefore, it can be detrimental if overdosing occurs, where it can induce anticholinergic, hallucinogenic, psychotropic poisoning or even death. In this case, possible risks of purchasing TCM over the counter, and possible adverse events from Datura metel ingestion. Physostigmine was not used to treat the patient’s anticholinergic toxidromes as there are studies demonstrating either the length of hospital stay or duration of intensive care use do not decrease with such measure.

The widely and inappropriate usage of herbal medicine is a main concern in most parts of the world. Hence in cases of ‘unexplained’ anticholinergic poisoning, high index of suspicion of overdosing Datura metel should be raised.