Purpose: To report the first case in the ophthalmic literature of acute anticholinergic syndrome after ingestion of Atropa belladonna mistaken for blueberries.
Methods: A 36-year-old woman presented to our ophthalmic emergency department with complaints of blurry vision, lightning flashes, disorientation, loss of balance, agitation, and anxiety for 24 hours. Ophthalmic examination revealed bilateral pupillary dilatation and paresis of accommodation. Additional symptoms of the anticholinergic syndrome were elicited on further questioning.
Results: Anticholinergic intoxication was suspected and the patient admitted to have eaten six "blueberries" found in the forest the previous day. The patient identified Atropa belladonna as the source of the berries she had eaten when shown photographs of the plant and its fruit. The recommendations of the Swiss Toxicological Information Centre were followed and physostigmine, the antidote for severe poisoning when 10 or more berries are ingested, was not administered.
Conclusions: Accidental ingestion of Atropa belladonna berries may cause patients to first consult an ophthalmologist. It is important to recognize the anticholinergic syndrome caused by such intoxication in order to make a proper diagnosis, avoid unnecessary testing, and provide expedient appropriate treatment when required.
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http://dx.doi.org/10.1177/112067210901900130 | DOI Listing |
Cureus
January 2025
Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Anticholinergic toxicity typically presents with symptoms of cutaneous vasodilation, delirium, mydriasis, urinary retention, hyperthermia, anhidrosis, and tachycardia. This case report presents a 68-year-old female patient who exhibited some of these signs and symptoms after ingesting an unknown quantity of dicyclomine. However, she displayed one notable exception to the classic toxidrome.
View Article and Find Full Text PDFNat Rev Urol
January 2025
Sheffield Teaching Hospitals, Sheffield, UK.
A number of reports have suggested that the use of prolonged antibiotic treatment could be an effective therapy for patients with overactive bladder (OAB); however, this approach is contrary to existing recommendations regarding the prolonged non-specific use of antibiotics. The existing evidence in this area seems to be circumstantial and anecdotal but, despite this limitation, the use of long-term antibiotic therapy for OAB seems to be increasing. Review and synthesis of the existing evidence for use of antibiotic therapy in patients with OAB identify few studies - just seven papers and four conference proceedings - which are heterogeneous in their design, inclusion and exclusion criteria, treatment regimen employed, approach to the use of antimuscarinic medications, follow-up protocols, and measured outcomes.
View Article and Find Full Text PDFCureus
November 2024
Medicine, Hospital Vila Franca de Xira, Vila Franca de Xira, PRT.
Buckwheat () is a seed increasingly used as a gluten-free alternative, particularly by individuals with gluten-sensitive enteropathy. While rich in vitamins and minerals, it may also contain toxic secondary metabolites. The authors present a case of a 49-year-old female patient, admitted to the emergency department with a four-hour history of psychomotor agitation, confusion, and mydriasis.
View Article and Find Full Text PDFBMC Pharmacol Toxicol
December 2024
Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Background: H1-antihistamines are widely used to treat symptoms depending on histamine release in a variety of conditions. However, neurological adverse events have been reported in post-marketing surveillance studies and there are limited literatures comparing the neurological disorders associated with newer-generation H1-antihistamines from real-world datasets.
Aims: We performed a comparative analysis of nervous system disorders and several newer-generation H1-antihistamines including: cetirizine, loratadine, levocetirizine, desloratadine and fexofenadine.
Objective: The purpose of this study was to evaluate the effectiveness of the drugs Solifenacin and Vesusten in relation to the treatment of neurogenic bladder overactivity in multiple sclerosis (MS).
Materials And Methods: A prospective, single-site, single-center, placebo-controlled, parallel-group, comparative clinical trial was conducted. The study included 41 MS patients of both sexes aged 18-50 years with urodynamically confirmed detrusor overactivity.
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