Bajiaolian poisoning-a poisoning with high misdiagnostic rate.
BACKGROUND
One of the oldest Chinese herbal medicine, bajiaolian is widely used in traditional therapy. In Taiwan, bajiaolian is the fifth highest cause of poisoning among herbal medicines. The diagnosis is difficult because physicians are unfamiliar with this medicine's multiple presentations in different stages of intoxication.


METHODS
The records of 4 major poison centers in Taiwan were searched for all bajiaolian intoxication from July 1985 (the opening of first poison center) to March 2003. Two emergency physicians with toxicologic training reviewed the admission charts and visited case patients for follow-up.


RESULTS
Seventeen patients were identified, of which 15 (88.2%) had been misdiagnosed initially. In the beginning of their medical care, 14 cases were diagnosed as acute gastroenteritis.


CONCLUSIONS
Bajiaolian intoxication is probably misdiagnosed because of early gastrointestinal symptoms followed by neurologic symptoms. A detailed patient history should be taken, and symptoms should be reviewed systemically to improve diagnostic accuracy.
Chou
Shang-Lin
SL
Institute of Emergency Medicine and Critical Care Medicine, National Yang-Ming University, Taipei 11221, Taiwan, ROC.
Chou
Ming-Yueh
MY
Kao
Wei-Fong
WF
Yen
David H T
DH
Yen
Liang-Yu
LY
Huang
Chun-I
CI
Lee
Chen-Hsen
CH
D000293:Adolescent; D000328:Adult; D003951:Diagnostic Errors; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000506:poisoning*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced*; D011039:Poison Control Centers; D011041:Poisoning / Q000175:diagnosis*; D013624:Taiwan; D055815:Young Adult
D004365:Drugs, Chinese Herbal