title: Bajiaolian poisoning-a poisoning with high misdiagnostic rate.
abstract: 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.
authors.affiliation: Institute of Emergency Medicine and Critical Care Medicine, National Yang-Ming University, Taipei 11221, Taiwan, ROC.
authors.forename: Shang-Lin
authors.initials: SL
authors.lastname: Chou
authors.forename: Ming-Yueh
authors.initials: MY
authors.lastname: Chou
authors.forename: Wei-Fong
authors.initials: WF
authors.lastname: Kao
authors.forename: David H T
authors.initials: DH
authors.lastname: Yen
authors.forename: Liang-Yu
authors.initials: LY
authors.lastname: Yen
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Huang
authors.forename: Chen-Hsen
authors.initials: CH
authors.lastname: Lee
mesh_terms: 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
chemical_list: D004365:Drugs, Chinese Herbal