Oral lesions and pulmonary fibrosis after ingesting grapes

A young rural man referred to us with profound icterus and dyspnea after he had eaten three grapes almost 10 days earlier. He had referred to a local hospital 30 min after ingestion with nausea, vomiting and abdominal pain and was conservatively managed. He then became icteric and began to experience dyspnea and was referred to our center with an O(2) saturation of 77% and abnormal liver and renal function tests. Glossitis with a green-yellow pseudomembrane and subcutaneous emphysema were noticed. After detection of lung fibrosis in chest X-ray, he was put on the antioxidant and immunosuppressive therapy, but expired almost 20 h after admission.