A rare ingestion of the Black Locust tree.
BACKGROUND
The Black Locust (Robinia Pseudoacacia) tree contain toxalbumins, robin and phasin, that exert their toxic effects by inhibition of protein synthesis. Despite the potential dangers of Black Locust intoxication, reports of human toxicity after ingestion are rare. We report the first human intoxication of Black Locust bark in North America in over one hundred years.


METHODS
An eight-year-old male was brought to the emergency department 6 hours after chewing and expelling the Black Locust bark. He presented with emesis, which began approximately 2.5 hours after exposure. His vital signs were as follows: oral temperature, 97.5 degrees F; blood pressure, 128/75 mmHg; heart rate, 114 beats per minute; respiratory rate, 15 breaths per minute. Initial treatment included 4 mg i.v. ondansetron, which resolved the vomiting, one dose of activated charcoal, and intravenous fluids. He was then admitted to the intensive care unit (ICU) for observation of signs of toxicity. Laboratory findings were unremarkable except for a white blood cell of 18.4 K/uL and an elevated alkaline phosphatase of 183 U/L. The patient remained asymptomatic throughout his stay in the ICU and was discharged on the fifth day of admission with a normal white blood cell of 4.1 K/uL and an alkaline phosphatase of 251 U/L.


CONCLUSIONS
Patients with clinical toxicity following the ingestion of Black Locust are expected to do well with supportive care and observation.
Hui
Alan
A
Central New York Poison Control Center, Department of Emergency Medicine, University Hospital, SUNY Upstate Medical University, Syracuse, New York, USA.
Marraffa
Jeanna M
JM
Stork
Christine M
CM
D000932:Antiemetics / Q000627:therapeutic use; D002648:Child; D006801:Humans; D008297:Male; D017294:Ondansetron / Q000627:therapeutic use; D010166:Palliative Care; D024301:Plant Bark / Q000506:poisoning*; D010939:Plant Poisoning / Q000209:etiology* / Q000503:physiopathology; D031301:Robinia / Q000506:poisoning*; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy / Q000209:etiology
D000932:Antiemetics; D017294:Ondansetron