Toad Poisoning: Clinical Characteristics and Outcomes
Satariya Trakulsrichai1,2, Kritsada Chumvanichaya1,3, Charuwan Sriapha2
1Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Therapeutics and Clinical Risk Management
|December 28, 2020
Summary
Toad poisoning in Thailand frequently caused gastrointestinal issues and bradycardia. Severe cases led to cardiac arrest and death, but tachyarrhythmia was not observed. Supportive care is crucial for managing toad poisoning.
Area of Science:
- Toxicology
- Clinical Medicine
- Public Health
Background:
- Toad poisoning is a significant health concern in Thailand.
- Understanding the clinical manifestations and outcomes is crucial for effective management.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of toad poisoning patients in Thailand.
- To identify common symptoms, complications, and mortality rates associated with toad poisoning.
Main Methods:
- A retrospective study was conducted using data from the Ramathibodi Poison Center Toxic Exposure Surveillance System.
- Data from 36 patients with confirmed toad poisoning between 2012 and 2016 were analyzed.
Main Results:
- Gastrointestinal symptoms were the most common presentation, occurring within 2 hours of ingestion.
- Bradycardia (12 patients) and shock (7 patients) were frequent, with 3 deaths occurring in severe cases.
- Hyperkalemia was observed in 11.1% of patients; digoxin was detected in 5 of 7 tested.
- Supportive care, including GI decontamination and management of hyperkalemia, was administered. One patient improved after receiving digoxin-specific antibody fragments (DsFab).
Conclusions:
- Toad poisoning typically presents with gastrointestinal symptoms and bradycardia.
- Severe poisoning can lead to cardiac arrest and mortality, though tachyarrhythmias were not observed.
- Supportive and symptomatic care are the primary treatment modalities, particularly when DsFab is unavailable.
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