An unusual case of anisocoria by vegetal intoxication: a case report.

Italian Journal of Pediatrics
Marina MacchiaioloAlberto Villani

Abstract

A 12 year old boy presented with an acute onset of anisocoria and blurred vision. Ocular motility was normal but his right pupil was dilated, round but sluggishly reactive to light. There was no history of trauma, eye drops' instillation, nebulised drugs or local ointments. His past medical history was negative.A third nerve palsy was considered but the performed cerebral MRI was normal.On further anamnestic investigation the boy revealed that he had spent the morning doing gardening, and especially working on a "trumpet plant". Datura and Brugmansia are well known toxic plant; all Datura and Brugmasia plants contain, primarily in their seeds and flowers, tropane alkaloids such as scopolamine, hyoscyamine and atropine. Systemic and local intoxications have already been described.The day after anisocoria was much less evident and completely resolved in three days.We present this case of an unusual cause of mydriasis to underline once more the importance of a well and deeply conducted medical history.

References

Aug 22, 2003·MMWR. Morbidity and Mortality Weekly Report·UNKNOWN Centers for Disease Control and Prevention (CDC)
Dec 3, 2005·Evidence-based Complementary and Alternative Medicine : ECAM·James D Adams, Cecilia Garcia
Jul 17, 2007·The Journal of Emergency Medicine·Daniel Firestone, Christian Sloane
Mar 26, 2008·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Barbara AndreolaElsa Cappelletti

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Citations

Mar 9, 2012·Medicina clínica·Sonia Jaraba ArmasSergio Martínez-Yélamos
Feb 12, 2021·Journal of Ethnopharmacology·Adnan Mohammed AlgradiHai-Xue Kuang

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