Case Report of Lethal Toxin Lurking in an Edible Plant

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Pallav Patel
Venu Madhav Konala
Sreedhar Adapa
Vijay Gayam
Prem Sahasranam
Subhasish Bose
Candice D Golez
Srikanth Naramala


Cassava, Cyanide poisoning, Sodium nitrite, Hydroxycobalamine, Sodium thiosulfate


Cyanide is notoriously known to the public for more than a century now as a weapon of mass destruction (Zyklon B gas - Hydrogen Cyanide used by Nazis), an agent for chemical warfare during World War I (Hydrogen Cyanide) and very infamous “Suicide Pill” used in the past by Military and Espionage organizations during World War II (Potassium Cyanide). During the modern industrial era, Cyanide poisoning is commonly associated with industrial exposure and domestic fires. But there is little awareness about potentially fatal consequences of cyanide poisoning from common food sources. Here, we present the case of 79-year-old Chinese female with acute Cyanide poisoning from improperly prepared Cassava leaves.

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1. Mowry JB, Spyker DA, Patel P, Konala VM, Adapa S. Annual report of the American associa-tion of poison control centers, National poison data system (2013–2017). annual-reports (accessed on: July 30, 2019).
2. Cock JH. Cassava: New potential for a neglected crop. Kasese: CRC Press, 2019.
3. Alitubeera PH, Eyu P, Kwesiga B, et al. Outbreak of cyanide poisoning caused by consumption of cassava flour-Kasese District, Uganda, September 2017. MMWR Morb Mortal Wkly Rep 2019;68: 308–11.
4. Bradbury JH. Simple wetting method to reduce cyanogen content of cassava flour. J Food Compos Anal 2006;19:388–93.
5. Gonzales J, Sabatini S. Cyanide poisoning: Pathophysiology and current approaches to therapy. Int J Artif Organs 1989;12:347–55.
6. Morocco AP. Cyanides. Crit Care Clin 2005; 21:691–705.
7. Chen KK, Rose C, Clowes G. Amyl nitrite and cyanide poisoning. JAMA 1933;100:1921–2.
8. Chen KK, Rose C. Nitrite and thiosulfate therapy  in cyanide poisoning. JAMA 1952;149: 113–9.
9. Curry SC, Carlton MW, Raschke RA. Prevention of fetal and maternal cyanide toxicity from nitro-prusside with coinfusion of sodium thiosulfate in gravid ewes. Anesth Analg 1997;84:1121–6.
10. Uhl W, Nolting A, Golor G, et al. Safety of hydroxocobalamin in healthy volunteers in a ran-domized, placebo-controlled study. Clin Toxicol 2006;44:17–28.
11. Thompson JP, Marrs TC. Hydroxocobalamin in cyanide poisoning. Clin Toxicol 2012;50: 875–85.