Cyanide Intoxication after Ingestion of Wild Cherry (Prunus Avium)

Case Report

Austin J Clin Case Rep. 2016; 3(1): 1083.

Cyanide Intoxication after Ingestion of Wild Cherry (Prunus Avium)

Yilmaz BK¹, Cevik E²*, Cerciz H¹, Yoruk M¹, Acar YA³, Cakmak F4 and Ikizceli I5

¹Department of Emergency Medicine, Sisli Hamidiye Etfal Research and Training Hospital, Turkey

²Department of Emergency Medicine, Van Military Hospital, Turkey

³Department of Emergency Medicine, Etimesgut Military Hospital, Turkey

4Department of Emergency Medicine, Balikligol Government Hospital, Turkey

5Department of Emergency Medicine, Istanbul University Cerrahpasa Medical School, Turkey

*Corresponding author: Erdem Cevik, Department of Emergency Medicine, Van Military Hospital, Van Asker Hastanesi Altintepe, Van, Turkey

Received: February 09, 2016; Accepted: April 06, 2016; Published: April 11, 2016


Intoxications are major public health problems and can be caused from wide range of substances. Plants can be toxic to human beings and animals. Cyanogenic plants are groups of plants cause cyanide intoxication. Wild cherry is one of cyanogenic plants. In this report, we presented a 67- year old man with cyanide intoxication after eating wild cherry. He was treated successfully with hydroxocobalamin administration.

Keywords: Cyanides; Poisoning; Wild cherry


Intoxications remain a major public health problem and plant poisonings constitutes 4.7% of all poisonings [1]. However rarely encountered, early diagnosis and proper management of cyanide intoxication is crucial because of probable fatal outcome. We reported a cyanide intoxication case after wild cherry ingestion.

Case Presentation

A 67-year old man was admitted to emergency department because of altered mental status. He had been complaining apathy, meaningless speech, and difficulty in identifying people for two days before admission. These complaints started after eating wild cherry in the forest. He denied any chronic disease and medication. His vital signs were BP: 152/73 mmHg, pulse rate: 73 bpm (regular), temperature: 36.0oC and SaO2: 94%. Heart and lung auscultation and systemic examination did not show any abnormality. The patient was lethargic, and there was no lateralization finding. Venous blood gas values showed a pH of 7.36; PCO2 of 45.6 mm Hg; PO2 of 41.6 mm Hg, HCO3 of 25.3 mmol/L SaO2 of 40.4%, lactate of 1.1 mmol/L, HHb of 58.1%, and COHb: 1.5%. Other laboratory analyses were all in normal ranges. Brain imaging (including MRI and CT) and lumber puncture were performed for differential diagnosis but any pathology could not be detected to explain the changes in consciousness.

Because of wild cherry ingestion history, cyanide intoxication was considered and the patient was hospitalized in the observation unit of emergency department. National Poison Control Center advised hydroxocobalamin therapy. The patient was 70kg weight and 5grams of hydroxocobalamin (Cyanokit®, Meridian Medical Technologies) administered intravenously in 30 minutes initially. Clinical findings were continued and a second dose (5grams) administered in 90 minutes. Symptoms were resolved quickly after second dose of hydroxocobalamin. After a 3-day follow up, patient discharged from emergency department without any complication (Figure 1).

Citation: Yilmaz BK, Cevik E, Cerciz H, Yoruk M, Acar YA, Cakmak F, et al. Cyanide Intoxication after Ingestion of Wild Cherry (Prunus Avium). Austin J Clin Case Rep. 2016; 3(1): 1083. ISSN : 2381-912X