Baniya Abinash, Duwadee Prabin, K C Sujata, Shahi Manoj, Shrestha Nabaraj, Bam Prabin K, Gurung Bipana, Shrestha Roshan
Chitwan Medical College, Bharatpur, Chitwan.
Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Ann Med Surg (Lond). 2023 Jun 7;85(7):3649-3652. doi: 10.1097/MS9.0000000000000899. eCollection 2023 Jul.
Mad honey contains grayanotoxin, which is commonly derived from the nectar of a few Rhododendron species. It is commonly used by natives of the Himalayas in the belief of its medicinal use.
The authors report a case of 62 years old male with mad honey poisoning who was presented to the emergency department with loss of consciousness and had bradycardia and hypotension on arrival. The patient received intravenous fluids, atropine, and vasopressor support and was closely monitored in the coronary care unit for 48 h.
Grayanotoxin I and II are believed to be primarily responsible for mad honey intoxication and act by persistent activation of voltage-gated sodium channels. Hypotension, dizziness, nausea, vomiting, and impaired consciousness are the common presentation of mad honey intoxication. Toxic effects are usually mild and close monitoring for 24-48 h is sufficient but life-threatening complications like cardiac asystole, convulsions, and myocardial infarction have also been reported.
Most cases of mad honey intoxication only need symptomatic treatment and close observation but the potential for deterioration and life-threatening complications must also be considered.
疯蜜含有杜鹃花毒素，通常源自几种杜鹃花的花蜜。喜马拉雅地区的当地人普遍使用它，认为其有药用价值。
作者报告了一例62岁男性疯蜜中毒病例，该患者因意识丧失被送至急诊科，入院时出现心动过缓和低血压。患者接受了静脉输液、阿托品和血管升压药支持治疗，并在冠心病监护病房密切监测48小时。
杜鹃花毒素I和II被认为是导致疯蜜中毒的主要原因，其作用机制是持续激活电压门控钠通道。低血压、头晕、恶心、呕吐和意识障碍是疯蜜中毒的常见表现。中毒效应通常较轻，密切监测24 - 48小时就足够了，但也有报告称出现过心脏停搏、惊厥和心肌梗死等危及生命的并发症。
大多数疯蜜中毒病例仅需对症治疗和密切观察，但也必须考虑病情恶化和危及生命并发症的可能性。
