Hidden intoxication with Datura stramonium: A case report

Datura stramonium is a hallucinogenic plant containing three main toxic alkaloids: atropine, scopolamine and hyosciamine. Intoxication with Datura is rare, occuring mostly among adolescents with potentially fatal outcome. Diagnosis is essentially clinical and sometimes difficult because typical signs and symptoms of Datura poisoning can be in accordance with clinical picture of other related injury. We report a case of hidden intoxication with Datura stramonium. The patient was admitted to ICU with symptoms of near-drowning and intoxication with Cannabis. On the second day of admission his neurological status was unexpectedly deteriorating which could not be explained with previously mentioned diagnosis. Finally we found out that Datura stramonium poisoning preceded near-drowning. Our case is a typical example how clinical signs and symptoms of Datura intoxication may not be recognised at time and delay the proper treatment. We missed to do the first step in Datura intoxication: gastric decontamination with activated charcoal, while other therapeutic measures were in accordance with Datura intoxication treatment. The patient was discharged from ICU after five days with no sequels. We conclude that even if Datura stramonium intoxication is rare we have to increase awareness of this possibility as to avoid pitfalls in early diagnostics and in treatment approach.