JIST

Abstract

Background : Cerbera odollam is a highly toxic plant found in South India, particularly Kerala. Its seeds contain cardiac glycosides, notably cerber in, which can cause life-threatening arrhythmias by inhibiting the Na⁺/K⁺-ATPase pump. Poisoning often presents with gastrointestinal and cardiac manifestations, and early intervention is essential.

Case series: We report three cases of Cerbera odollam poisoning presenting to atertiary care center in Kerala, between January and June 2019. The first case involved a 38-year-old male who ingested one fruit and presented with vomiting and oliguria; his ECG showed sinus bradycardia and atrioventricular (AV) block. He was successfully treated with temporary pacemaker insertion and recovered fully. The second case was a 56-year-old male who consumed one seed and developed bradyarrhythmias accompanied by hyperkalemia. Despite supportive care, pacemaker therapy was not initiated, and the patient unfortunately succumbed to the poisoning. The third case described a 42-year-old male who ingested three seeds and presented with altered consciousness and significant bradyarrhythmias, including conduction blocks. He was managed with temporary pacing and supportive treatment, leading to clinical recovery.

Conclusion: This case series emphasizes the critical role of temporary cardiac pacing in managing Cerbera odollam poisoning. Early diagnosis and timely intervention, particularly in the presence of conduction abnormalities, can be lifesaving.