Fábio Bucaretchi, Carla F Borrasca-Fernandes, Camila C Prado, Rafael Lanaro, José Luiz Costa, Otávio M Petroni, Tiago Giraldi, Maria Heloísa S L Blotta, Amauri S Justo-Junior, Natália L Sousa, Francisco J L Aragão, Eduardo M De Capitani, Stephen Hyslop
Objective: To report a near-fatal poisoning after intentional injection of ricin from a castor bean ( Ricinus communis ) extract. Case report: A 21 year-old man self-injected ∼3 mL of a castor bean extract intramuscularly and subcutaneously in the left antecubital fossa. Upon admission to our ED (1 h post-exposure; day 1, D1) he was awake and alert, but complained of mild local pain and showed slight local edema and erythema. He evolved to refractory shock (∼24 h post-exposure) that required the administration of a large volume of fluids and high doses of norepinephrine and vasopressin, mainly from D2 to D4...
June 1, 2020: Clinical Toxicology