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Toad Poisoning: Clinical Characteristics and Outcomes
OBJECTIVE: This study was performed to describe the clinical characteristics and outcomes of patients with toad poisoning in Thailand. METHODS: We carried out a retrospective study of patients with toad poisoning from the Ramathibodi Poison Center Toxic Exposure Surveillance System during a 5-year p...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752649/ https://www.ncbi.nlm.nih.gov/pubmed/33363378 http://dx.doi.org/10.2147/TCRM.S272863 |
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author | Trakulsrichai, Satariya Chumvanichaya, Kritsada Sriapha, Charuwan Tongpoo, Achara Wananukul, Winai |
author_facet | Trakulsrichai, Satariya Chumvanichaya, Kritsada Sriapha, Charuwan Tongpoo, Achara Wananukul, Winai |
author_sort | Trakulsrichai, Satariya |
collection | PubMed |
description | OBJECTIVE: This study was performed to describe the clinical characteristics and outcomes of patients with toad poisoning in Thailand. METHODS: We carried out a retrospective study of patients with toad poisoning from the Ramathibodi Poison Center Toxic Exposure Surveillance System during a 5-year period (2012–2016). RESULTS: We studied 36 patients poisoned by toad toxin. The median age was 31 years. Most patients were male (66.7%) and had ingested toad meat (50%). The most common presentation was gastrointestinal (GI) symptoms with a median onset of 2 h after ingestion. Twelve patients presented with bradycardia; seven presented with shock and one with cardiac arrest. In the initial EKGs of all patients, the most common abnormality was sinus bradycardia.Two patients developed cardiac arrest early during management in the emergency room (within 15 minutes after ER arrival or within 4.5 h after ingestion). During admission, one patient developed sinus bradycardia, and two developed bradyarrhythmia; however, all three were stable. No tachyarrhythmias such as ventricular tachycardia were detected in any patient. Some patients (11.1%) presented with hyperkalemia. Serum digoxin was detected in five of seven patients tested, ranging from 0.43 to >8 ng/mL. Most patients (75%) were admitted to the hospital; the median duration of hospitalization was 2 d (range 0.5–5 d). The overall mortality rate was 8.3%, and all three patients that died ate toad meat and/or eggs and developed cardiac arrest. All patients received supportive with/without symptomatic care including GI decontamination, inotropic drugs, cardiac pacing, and management of hyperkalemia. One patient received intravenous calcium for hyperkalemia but did not develop dysrhythmia after calcium administration. One patient received digoxin-specific antibody fragments (DsFab), after which he clinically improved and was discharged. CONCLUSION: Toad poisoning commonly caused GI symptoms and bradycardia. However, in severe cases, death occurred. Tachyarrhythmia was not observed. Supportive, symptomatic care might be the main therapies for this poisoning, especially if DsFab is not available. |
format | Online Article Text |
id | pubmed-7752649 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-77526492020-12-23 Toad Poisoning: Clinical Characteristics and Outcomes Trakulsrichai, Satariya Chumvanichaya, Kritsada Sriapha, Charuwan Tongpoo, Achara Wananukul, Winai Ther Clin Risk Manag Original Research OBJECTIVE: This study was performed to describe the clinical characteristics and outcomes of patients with toad poisoning in Thailand. METHODS: We carried out a retrospective study of patients with toad poisoning from the Ramathibodi Poison Center Toxic Exposure Surveillance System during a 5-year period (2012–2016). RESULTS: We studied 36 patients poisoned by toad toxin. The median age was 31 years. Most patients were male (66.7%) and had ingested toad meat (50%). The most common presentation was gastrointestinal (GI) symptoms with a median onset of 2 h after ingestion. Twelve patients presented with bradycardia; seven presented with shock and one with cardiac arrest. In the initial EKGs of all patients, the most common abnormality was sinus bradycardia.Two patients developed cardiac arrest early during management in the emergency room (within 15 minutes after ER arrival or within 4.5 h after ingestion). During admission, one patient developed sinus bradycardia, and two developed bradyarrhythmia; however, all three were stable. No tachyarrhythmias such as ventricular tachycardia were detected in any patient. Some patients (11.1%) presented with hyperkalemia. Serum digoxin was detected in five of seven patients tested, ranging from 0.43 to >8 ng/mL. Most patients (75%) were admitted to the hospital; the median duration of hospitalization was 2 d (range 0.5–5 d). The overall mortality rate was 8.3%, and all three patients that died ate toad meat and/or eggs and developed cardiac arrest. All patients received supportive with/without symptomatic care including GI decontamination, inotropic drugs, cardiac pacing, and management of hyperkalemia. One patient received intravenous calcium for hyperkalemia but did not develop dysrhythmia after calcium administration. One patient received digoxin-specific antibody fragments (DsFab), after which he clinically improved and was discharged. CONCLUSION: Toad poisoning commonly caused GI symptoms and bradycardia. However, in severe cases, death occurred. Tachyarrhythmia was not observed. Supportive, symptomatic care might be the main therapies for this poisoning, especially if DsFab is not available. Dove 2020-12-16 /pmc/articles/PMC7752649/ /pubmed/33363378 http://dx.doi.org/10.2147/TCRM.S272863 Text en © 2020 Trakulsrichai et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Trakulsrichai, Satariya Chumvanichaya, Kritsada Sriapha, Charuwan Tongpoo, Achara Wananukul, Winai Toad Poisoning: Clinical Characteristics and Outcomes |
title | Toad Poisoning: Clinical Characteristics and Outcomes |
title_full | Toad Poisoning: Clinical Characteristics and Outcomes |
title_fullStr | Toad Poisoning: Clinical Characteristics and Outcomes |
title_full_unstemmed | Toad Poisoning: Clinical Characteristics and Outcomes |
title_short | Toad Poisoning: Clinical Characteristics and Outcomes |
title_sort | toad poisoning: clinical characteristics and outcomes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752649/ https://www.ncbi.nlm.nih.gov/pubmed/33363378 http://dx.doi.org/10.2147/TCRM.S272863 |
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