The syndromic classification, differential diagnosis, management, and prevention of potentially fatal plant poisonings in Louisiana and the Gulf South.
The American Association of Poison Control Centers has reported more than 50,000 calls annually relating to plant exposures, usually non-lethal ingestions in young adults, adolescents, and children. In addition, there has been more than a 100% increase in the mortality rate for unintentional poisonings in the United States (US) between 1999 and 2006, especially in males and in individuals aged 15-29 years. For children, the frequency of plant exposures is directly related to their presence and abundance in households. In contrast, adolescents and young adults may experiment with naturally hallucinogenic plants, often obtained over the Internet, or attempt suicide by ingesting poisonous plants. In light of these recent trends in plant poisonings, the objectives of this investigation will be to propose a rapid syndromic classification scheme of only four types of highly toxic plants (cardiotoxic, neurotoxic, cytotoxic, and gastrointestinalhepatotoxic) for the initial evaluation of patients poisoned by indigenous and often unidentified toxic plants in Louisiana and the Gulf South. It will also discuss current strategies for early diagnosis, management, and prevention of potentially lethal plant poisonings. Although many plants contain toxins, plants provide more than 70% of new drugs today and continue to provide new therapies for infectious diseases and cancer. More leisure time spent outdoors seeking natural foods and surfing the Internet for natural substances to abuse will create more opportunities for plant poisonings among high-risk groups, such as immigrants foraging for greens and adolescents experimenting with natural hallucinogens.