Department of Medicine, Ratchaburi Hospital, Ratchaburi Province, Thailand.
Clin Toxicol (Phila). 2011 Nov;49(9):834-9. doi: 10.3109/15563650.2011.618456. Epub 2011 Oct 5.
Bamboo shoots contain cyanogenic glycosides named taxiphyllin. Cyanide poisoning from cyanogenic glycosides commonly occurs following ingestion. However, toxicity caused by inhalation of hydrogen cyanide gas (HCN) produced from pickled shoots has never been reported.
To describe cyanide poisoning in eight victims who were exposed to HCN produced in a well containing pickling bamboo shoots.
Due to a series of botched rescue attempts, a total of eight patients entered into a 27 m(3) well containing pickled bamboo shoots and immediately lost consciousness. After rescue, two patients developed cardiac arrest, metabolic acidosis and died. Four other patients suffered metabolic acidosis, but recovered after supportive care. The remaining two regained consciousness and recovered soon after the event. Ambient air study and cyanide content of bamboo shoots helped confirm the diagnosis.
All patients had high anion gap metabolic acidosis with normal oxygenation. Blood cyanide levels ranged from 2.66 to 3.30 mcg/ml (taken after about 18 h of incident). Ambient air study (21 h after incident) revealed oxygen 20.9%, and sulfur dioxide 19.4 ppm. The instrument was unfortunately not equipped to detect HCN. A simulation study revealed HCN and sulfur dioxide in the ambient air at 10 ppm and 7.5 ppm, respectively. Cyanide content in the bamboo shoots ranged from 39 to 434 mg/kg in the wet shoots.
This series of patients developed sudden onset of alteration of consciousness and metabolic acidosis upon exposure, and cyanide was confirmed in all victims. The simulation study confirmed the presence of HCN in the ambient air of the well containing bamboo shoots.
We have reported mass acute cyanide poisoning with two fatalities. The source of HCN was unusual as it was produced from pickling bamboo shoot.
竹笋含有一种名为 Taxiphyllin 的氰苷。氰苷通常通过摄入导致氰化物中毒。然而，从未有报道称食用腌制竹笋产生的氰化氢（HCN）气体吸入会导致中毒。
描述 8 名因摄入含有腌制竹笋的水井中产生的 HCN 而中毒的患者。
由于一系列救援失误，共有 8 名患者进入一个含有腌制竹笋的 27 立方米水井中，立即失去意识。救援后，2 名患者出现心脏骤停、代谢性酸中毒并死亡。另外 4 名患者发生代谢性酸中毒，但经支持性治疗后康复。其余 2 名患者意识恢复，事件发生后不久即康复。环境空气研究和竹笋中的氰化物含量有助于确诊。
所有患者均有高阴离子间隙代谢性酸中毒，氧合正常。血液氰化物水平为 2.66 至 3.30 mcg/ml（事发后约 18 小时）。事发后 21 小时的环境空气研究显示，氧气为 20.9%，二氧化硫为 19.4 ppm。仪器遗憾地没有配备检测 HCN 的功能。模拟研究显示，环境空气中 HCN 和二氧化硫的浓度分别为 10 ppm 和 7.5 ppm。湿竹笋中的氰化物含量为 39 至 434 mg/kg。
这一系列患者在暴露后突然出现意识改变和代谢性酸中毒，所有患者均检测到氰化物。模拟研究证实，含有竹笋的水井环境空气中存在 HCN。
我们报告了一起由食用腌制竹笋导致的 2 例死亡的群体急性氰化物中毒事件。HCN 的来源不同寻常，因为它是由腌制竹笋产生的。
