Severe uvular edema and resulting hypoxemia due to single use of Ecballium elaterium extract

BACKGROUND: Ecballium elaterium (also known as squirting cucumber in the Mediterranean countries) is a weedy plant that belongs to the Cucurbitacea family. The roots and juice of its fruits were used traditionally against a wide range of diseases and symptoms, since it was known for its anti-inflammatory and analgesic effects. The use of the extract, though, has been linked to allergic reactions and toxic effects. In this report, we present a case of severe uvular edema and hypoxemia due to a single use of Ecballium elaterium extract, and we discuss the possibility of life-threatening conditions resulting from the utilization of this particular plant as a remedy. CASE REPORT: A male Caucasian presented to the ER with complaints of troubled breathing and retrosternal discomfort that started a few hours before arriving at the ER. The patient’s medical history revealed the use of Ecballium elaterium extract. Clinical examination confirmed severe uvular edema and hypoxemia. Administration of oxygen and IV drugs (Hydrocortisone) relieved the symptoms and improved the patient’s condition. After a 24-hour hospitalization the patient was discharged without further complaints. CONCLUSIONS: The use of Ecballium elaterium extract as a remedy can cause severe adverse effects that should not be ignored. Uvular edema is one of the most common and can lead, as shown above, to hypoxemia, which is a potentially life-threatening condition.