(CR8) Acute Delirium with Anticholinergic Toxidrome from Datura Stramonium Ingestion

Introduction:

Datura stramonium (DS) is a wild plant containing various alkaloids including atropine, scopolamine and hyoscyamine, which have both hallucinogenic and anticholinergic properties. Ingestion of its seeds,flowers, roots, or the entire plant can lead to acute delirium with anticholinergic toxidrome.

Case Presentation :

We report a case of 60-year-old male who was admitted to Emergency Department with sudden onset of disorientation, blurring of vision, generalised lethargy, and urinary retention. Stroke protocol was initially activated however he did not have definite focal neurological deficit. His pupils were dilated but reactive. Urgent Computed Tomography of brain and angiography were normal. He was agitated and clinically dehydrated, intravenous fluid was administered. With supportive management, he regained full consciousness after 12 hours from the presentation. He recalled experiencing visual hallucinations and restlessness 3 hours after ingesting 10 raw seeds of DS. His electrocardiogram, kidney function and creatine kinase level were normal. He was discharged well and informed on the potential life-threatening adverse effects of DS.

Conclusion :

Clinicians should have a high index of suspicion of DS poisoning when a patient presented with acute delirium with anticholinergic toxidrome. Symptomatic treatment is the mainstay of therapy.