PP128 The Mysterious Jar of Homemade Chocolate

Abstract

THE MYSTERIOUS JAR OF HOMEMADE CHOCOLATE

 MDF Yazid¹, Joanne MH Hng¹, MS Mian¹, AZ Zahedi²

¹Department of Emergency and Trauma, Hospital Sultanah Aminah, Johor Bahru, Malaysia

²Academic Unit Trauma & Emergency Faculty of Medicine University of Malaya Kuala Lumpur

Apart from snake bites, toxin-related disease can also be caused by ingestion of animal or plant toxin found in food products . We reported a case of a toxin-related disease from consumption of a homemade food product that was sold   in one of the night bazaar in Johor Bahru. Mr.NN is a healthy 19 year old male. He was presented to the Emergency and Trauma Department (ETD) in Hospital Sultanah Aminah, with the acute complaint of inability to speak, associated with headache, nausea and not being his normal self. Neurological, cranial nerves and other systemic examinations were normal, besides his stammering speech. Point of care investigations including Full Blood Count, Electrocardiogram and X-Rays showed no abnormalities. Further urine tox screen and CT brain imaging were all normal. Subsequent collateral history from patient’s sister revealed he had been ‘hooked up’ on a homemade chocolate treat that he bought from a local night bazaar. The sister claimed the patient developed stammering speech and mild agitation with restlessness an hour after he took the homamade chocolate the night before presentating to ETD. He was treated as probable toxin induced stammering secondary to homemade chocolate ingestion. His symptoms resolved gradually over three days in medical ward and was discharged well. Natural occuring toxins from animal or plant can sometimes be found in homemade food products, and sometimes causes unfavourable clinical presentation and outcome. Oweing to the lack of research, governence, regulation and licensing during the process of manufacturing and selling. Timely detection of these toxins is fundamental in patient’s management, as well as preventing further widespread of such toxins in the community. Nevertheless, there is little awareness and knowledge in handling, sampling and testing of suspected contaminated food product at the hospital level; hence resulting in an unsolved mystery as presented in this case.