Taha S A, Mahdi A H
Trans R Soc Trop Med Hyg. 1984;78(1):134-5. doi: 10.1016/0035-9203(84)90196-2.
Cases of stramonium poisoning due to deliberate abuse by young adults have been widely reported. There are also a few reports of accidental poisoning in children from contaminated food. The taste and shape of Datura stramonium makes it unattractive to both man and animals and, therefore, ingestion by children in ignorance of its toxicity is rare. Three such cases are described in this paper. In Saudi Arabia stramonium abuse is unheard of and poisoning of children as a result of food contamination is very unlikely. Cases of ingestion in ignorance are, however, likely to occur frequently since D. stramonium grows in many parts of the country. The doses taken under the circumstances, though toxic, were small. The patients, therefore, suffered mainly the peripheral signs of the anti-cholinergic action of atropine, the principal D. stramonium alkaloid. Central nervous system manifestations and toxic psychosis were minimal in contrast to intentional misuse or accidental poisoning. Due to the special susceptibility of children to atropine toxicity and the relatively small lethal dose (less than or equal to 10 mg), treatment with the specific antidote, physostigmine salicylate, is emphasized for all but the mildest cases, in addition to any symptomatic treatment that might be needed.
青少年故意滥用曼陀罗致中毒的病例已有广泛报道。也有少数关于儿童因食用受污染食物而意外中毒的报告。曼陀罗的味道和形状使其对人和动物都缺乏吸引力,因此儿童在不知情的情况下误食的情况很少见。本文描述了三例此类病例。在沙特阿拉伯,从未听说过有滥用曼陀罗的情况,因食物污染导致儿童中毒的可能性也极小。然而,由于曼陀罗在该国许多地区都有生长,不知情误食的情况可能经常发生。在这种情况下摄入的剂量虽有毒,但很小。因此,患者主要表现出主要曼陀罗生物碱阿托品抗胆碱能作用的外周体征。与故意误用或意外中毒相比,中枢神经系统表现和中毒性精神病很轻微。由于儿童对阿托品毒性特别敏感且致死剂量相对较小(小于或等于10毫克),除了可能需要的任何对症治疗外,对于所有但最轻微的病例,都强调使用特效解毒剂水杨酸毒扁豆碱进行治疗。