Euphorbia tirucalli exposures reported to Texas poison centers

Introduction:Euphorbia tirucalli, commonly known as pencil cactus, is a member of the Euphorbiaceae family that produces a milky, white latex substance that can cause local irritation if ingested or comes in contact with the skin or eyes. This study characterized E. tirucalli exposures reported to a large, statewide poison center network.Methods: Cases were E. tirucalli exposures reported to the Texas Poison Center Network (TPCN) during 2000-2018. The distribution of cases was determined for various factors related to patient demographics, exposure circumstances, management, and outcome.Results: Of 678 total E. tirucalli exposures, the patient age distribution was 16.8% five years or less, 8.0% 6-12 years, 1.6% 13-19 years, and 72.1% 20 years or more; 55.6% were male. The most common exposure routes were ocular (60.9%), ingestion (31.9%), and dermal (17.3%). The exposure reason was unintentional in 97.5% of the exposures and occurred at the patient's own residence in 94.4%. The patient was managed outside of a healthcare facility in 66.5% of the cases, and 17.1% had potentially serious outcomes. The most common reported clinical effects were ocular (60.0%), dermal (14.0%), and gastrointestinal (12.1%).Conclusion: The majority of patients involved in E. tirucalli exposures reported to the TPCN were adults and male. The most common routes of exposure and clinical effects were ocular, ingestion, and dermal contact. Such information may prove useful for targeting education and prevention activities relating to E. tirucalli exposures.