Acute airway compromise after brief exposure to a Dieffenbachia plant

Dieffenbachia is a common domestic plant. Oral contact with the plant usually is associated with minimal consequences. However, chewing on the stem or the leaf of the Dieffenbachia can result in painful oropharyngeal edema and the inability to speak or handle secretions. Airway compromise has been reported only in a pediatric ingestion. We report a case of an adult who bit into the stem of the plant thinking it was sugar cane. He instantly spit out the remaining stem and despite this brief exposure, oropharyngeal edema developed refractory to medicinal therapy, requiring surgical airway management. The exact mechanism of edema is not known; therefore, methods of treatment are variable. We recommend caution when presented with a patient exposed to Dieffenbachia. Even the patient who initially seems stable may have an airway that will quickly deteriorate.