Colocynth induced multiorgan toxicity: a case report

Citrullus colocynthis, a plant traditionally used for its purgative properties, is known for its severe toxicity when consumed in excessive amounts. This case highlights the multiorgan toxicity of colocynth and underscores the need for increased public awareness to prevent such poisoning. The rapid onset of symptoms, absence of infectious causes, and prompt recovery with supportive care strongly support the diagnosis of colocynth-induced toxicity. It is the first reported case of colocynth poisoning from Eastern Africa. Given its widespread use in herbal medicine, this study raises awareness about its potential toxicity and contributes valuable clinical insights for managing similar cases in the future.

A 64-year-old Black male Somali of Cushitic ethnicity ingested colocynth fruit to relieve constipation. Within 2 hours, he developed profuse bloody diarrhea, hematemesis, and altered consciousness. On admission, he presented with hypotension, sinus tachycardia, leukocytosis, acute kidney injury, and elevated liver enzymes. Diagnostic workup ruled out infections and other causes of colitis. Management included aggressive fluid resuscitation, antibiotics, and supportive care, leading to full recovery within 5 days.

This case highlights the multiorgan toxicity of colocynth, including gastrointestinal, hepatic, renal, and cardiovascular effects. It emphasizes the importance of recognizing the toxic potential of colocynth and the need for public education to prevent similar incidents. The rapid onset of symptoms and prompt recovery with supportive care underscore the clinical significance of this case.