title: Upper airway edema resulting from use of Ecballium elaterium.
abstract: OBJECTIVE
  To present a rare occurrence in ear, nose and throat practice of upper airway allergic edema from use of juice extracted from the fruit of Ecballium elaterium.
  
  
  BACKGROUND
  Ecballium elaterium is a plant indigenous to the Mediterranean region that bears the common name squirting cucumber. Many people in this region for the treatment of sinusitis use the juice of its fruit. However, allergy-prone patients after using it may sometimes present with edema at various sites of the upper respiratory tract. Otolaryngologists are frequently asked to diagnose and treat such an emergency situation.
  
  
  METHODS
  Retrospective review of the records of 42 patients with this condition during the last 4 years.
  
  
  METHODS
  Patient records were retrospectively reviewed for age, sex, presenting symptoms, physical examination, and medical treatment. Seasonal distribution and data from the history of the patients were also considered. Skin prick and prick-to-prick testing to various allergens was performed in 12 patients.
  
  
  RESULTS
  Most of the patients presented with localized swelling of the uvula and the nasal mucosa, whereas in the remainder of the patients various sites of swelling of the upper respiratory tract were observed. Skin tests elicited positive reactions to pollen weeds and to various fruits of the Cucurbitaceae family. Treatment of the patients with corticosteroids and antihistamines resulted in an uneventful recovery, and we did not need to resort to therapeutic modalities, such as intubation or tracheotomy.
  
  
  CONCLUSIONS
  We think a further study of the pharmaceutical properties of the plant's fruit juice is needed, especially regarding its curative properties of rhinitis and sinusitis. However, adverse reactions in some patients with a positive history of allergy should always be considered.
authors.affiliation: Ear, Nose and Throat, Tzanion General Hospital of Piraeus, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Kloutsos
authors.forename: D G
authors.initials: DG
authors.lastname: Balatsouras
authors.forename: A C
authors.initials: AC
authors.lastname: Kaberos
authors.forename: D
authors.initials: D
authors.lastname: Kandiloros
authors.forename: E
authors.initials: E
authors.lastname: Ferekidis
authors.forename: C
authors.initials: C
authors.lastname: Economou
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019662:Cucurbitaceae; D004487:Edema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D006115:Greece; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods; D008517:Phytotherapy; D010936:Plant Extracts / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012621:Seasons; D012852:Sinusitis / Q000628:therapy; D012882:Skin Tests; D013256:Steroids; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D006634:Histamine H1 Antagonists; D010936:Plant Extracts; D013256:Steroids