A Bitter Experience-A Bitter Apple (Citrullus colocynthis) Ingestion in a Child

Area of Science:

• Toxicology
• Pediatric Gastroenterology
• Herbal Medicine Safety

Background:

• Herbal remedies are widely used, but their safety, especially in pediatric populations, requires careful consideration.
• Citrullus colocynthis (bitter apple) is a plant with a history of traditional use, but also known toxic potential.

Observation:

• A 4-year-old child presented with hemorrhagic colitis after accidental ingestion of Citrullus colocynthis, administered for constipation.
• The causative agent was confirmed to be Citrullus colocynthis.
• The child required supportive care, and associated symptoms included hypoglycemia and transaminitis.

Findings:

• Citrullus colocynthis ingestion can induce hemorrhagic colitis in children.
• Pediatric patients may be inadvertently exposed to harmful herbal medications.
• Toxic herbal agents can present in emergency departments far from the plant's origin.

Implications:

• Clinicians should consider toxic herbal ingestions in pediatric cases of unexplained gastrointestinal distress.
• Awareness of the potential toxicity of commonly used herbal remedies like bitter apple is crucial for public health.
• This case underscores the importance of educating caregivers about the risks associated with administering unverified herbal treatments to children.