Fatal outcome following the application of Nicotiana Glauca.L. in the framework of the traditional pharmacopoeia

Abstract

We report a case of intoxication following the application of the plant Nicotiana Glauca.L for the traditional treatment of skin burns. It is about a 5 years old girl, without remarkable medical history, who was the victim of a 3rd degree skin burn. The family applied the ground leaves of the plant Nicotiana Glauca.L. on all the skin lesions. After half an hour, the little girl presented vomiting and dizziness. The symptoms developed into hypotonia with consciousness disorders, which motivated the family to consult the emergency room. On admission, clinical examination found a dehydrated patient, unconscious, a pupil in mydriasis. After resuscitation measures, the patient was recovered. A biological check-up showed signs of rhabdomyolysis and multi-visceral damage. Toxicological research revealed the presence of anabasin and nicotine by gas and liquid chromatography coupled with mass spectrometry in the patient's urine. Botanical identification also determined the species of the plant. Despite resuscitation measures and symptomatic treatment, the evolution was unfortunately marked by death. Intoxication by Nicotiana Glauca.L. is rarely described in literature. The clinical picture is characterized by a nicotinic syndrome. The evolution can be fatal.