Citation

Espinosa J, Lucerna A, Bassett R. Am. J. Emerg. Med. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.ajem.2022.07.011

PMID

35821084

Abstract

Here we present the case of a 4-year-old child who presented to the emergency department (ED) with bloody diarrhea. The causative agent was confirmed to be Citrullus colocynthis (bitter apple), which had been given to the patient by his grandmother for constipation. Hemorrhagic colitis can be induced by Citrullus colocynthis. Treatment is essentially support. Hypoglycemia and transaminitis have been associated with Citrullus colocynthis ingestion. The case highlights that pediatric patients can be inadvertently exposed to herbal medications that can cause harm. It also highlights that certain herbal medications with toxic potential, such as Citrullus, can be seen in emergency departments that are geographically quite distant from the most common origins of the plant. To our knowledge, this is the first American pediatric case report of bitter apple induced hemorrhagic colitis.

Language: en

Keywords

Bitter apple poisoning; Hemorrhagic colitis due to Citrullus colocynthis (bitter apple) ingestion