title: Double lethal coconut crab (Birgus latro L.) poisoning.
abstract: We report a double lethal coconut crab Birgus latro L. poisoning in New Caledonia. Both patients died after showing gastro-intestinal symptoms, major bradycardia with marked low blood pressure, and finally asystolia. Both had significative hyperkaliemia, suggesting a digitaline-like substance intoxication. Traditional knowledge in the Loyalty Islands relates coconut crab toxicity to the consumption of the Cerbera manghas fruit by the crustacean. Elsewhere previous descriptions of human poisoning with the kernel of fruits of trees belonging to the genus Cerbera, known to contain cardiotoxic cardenolides, appear to be very similar to our cases. Cardenolides assays were performed on patient's serum samples, fruit kernel and on the crustacean guts, which lead us to suppose these two fatal cases were the result of a neriifolin intoxication, this toxin having been transmitted through the coconut crab.
authors: SAMU/SMUR/SAU/UHCD [Emergency Department], Territorial Hospital of New Caledonia, P.O. Box J5, 98849 Noumea, New Caledonia. claudemaillaud@yahoo.com.au
authors: C
authors: C
authors: Maillaud
authors: S
authors: S
authors: Lefebvre
authors: C
authors: C
authors: Sebat
authors: Y
authors: Y
authors: Barguil
authors: P
authors: P
authors: Cabalion
authors: M
authors: M
authors: Cheze
authors: E
authors: E
authors: Hnawia
authors: M
authors: M
authors: Nour
authors: F
authors: F
authors: Durand
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D033381:Anomura / Q000737:chemistry*; D029062:Apocynaceae / Q000737:chemistry / Q000506:poisoning*; D001919:Bradycardia / Q000097:blood / Q000209:etiology; D002298:Cardenolides / Q000032:analysis / Q000097:blood / Q000506:poisoning*; D054715:Cardiotoxins / Q000506:poisoning*; D017809:Fatal Outcome; D005638:Fruit / Q000737:chemistry / Q000506:poisoning*; D041981:Gastrointestinal Tract / Q000737:chemistry; D006323:Heart Arrest / Q000097:blood / Q000209:etiology; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000209:etiology; D007022:Hypotension / Q000097:blood / Q000209:etiology; D008297:Male; D009510:New Caledonia; D010947:Plants, Toxic / Q000737:chemistry; D057096:Shellfish Poisoning
chemical_list: D002298:Cardenolides; D054715:Cardiotoxins; C040684:neriifolin