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SMITH Science Day 2022, Aachen, Germany, 23 Nov 2022 - 23 Nov 2022; German Medical Science GMS Publishing House (2023). doi:10.3205/22SMITH01, Published by German Medical Science GMS Publishing House

Latein und Griechisch in Nordrhein-Westfalen, Bd. 1 Nr. 1 (2020): Tag der offenen Tür

Latein und Griechisch in Nordrhein-Westfalen, Bd. 3 Nr. 1 (2022): Lieblingstexte

BACKGROUND: Questions on poisoning by plants are a common reason for inquiries to poison information centers (PIC). Over the years 2011–2020, plant poisoning was the subject of 15% of all inquiries to the joint poison information center in Erfurt, Germany (Gemeinsames Giftinformationszentrum Erfurt, GGIZ) that concerned poisoning in children (2.3% in adults). In this patient collective, plant poisoning occupied third place after medical drugs (32%) and chemical substances (24%), and was a more common subject of inquiry than mushroom poisoning (1.5%). METHODS: This review is based on pertinent publications retrieved by a selective literature search in PubMed/TOXLINE on plant poisoning and on 12 epidemiologically and toxicologically relevant domestic species of poisonous plants in risk categories 2 and 3 (up to 2021). RESULTS: Medical personnel should have basic toxicological knowledge of the following highly poisonous plants: wolfsbane (aconitum), belladonna, angel’s trumpet, cowbane (cicuta virosa), autumn crocus, hemlock, jimson weed, henbane, castor bean (ricinus), false hellebore, foxglove (digitalis), and European yew. The intoxication is evaluated on the basis of a structured history (the “w” questions) and the clinical manifestations (e.g., toxidromes). Special analysis is generally not readily available and often expensive and time-consuming. In case of poisoning, a poison information center should be contacted for plant identification, risk assessment, and treatment recommendations. Specimens of plant components and vomit should be obtained, if possible, for further testing. Measures for the elimination of the poisonous substance may be indicated after a risk–benefit analysis. Specific antidotes are available for only a few types of plant poisoning, e.g., physostigmine for tropane alkaloid poisoning or digitalis antibodies for foxglove poisoning. The treatment is usually symptomatic and only rarely evidence-based. Individualized medical surveillance is recommended after the ingestion of large or unknown quantities of poisonous plant components. CONCLUSION: The clinician should be able to recognize dangerous domestic species of poisonous plants, take appropriate initial measures, and avoid overdiagnosis and overtreatment. To improve patient care, systematic epidemiological and clinical studies are needed.

Additional file 1: Figure S1. Visualization of plasmids of strain 537-20 by native plasmid preparation (Plasmid Mini Kit, Qiagen, Hilden, Germany) and agarose gel electrophoresis. The plasmid containing E. coli strain V515 was used as a reference (lane M). Several plasmids were visible in strain 537-20 (lane 1).Plasmid sizes that were bioinformatically identified are indicated on the right. Figure S2. LASTZ alignment of p537-20_1 (CP091535) and Conserved Virulence Plasmidic (CVP) region (HF922624). In the top panel, plasmid p537-20_1 was aligned to the CVP region (HF922624, reference) using LASTZ. The LASTZ algorithm allows to identify regions of similarity as indicated in the “LASTZ Alignment Graph". Blue regions indicate identity, whereas red regions indicate inversions compared to the reference sequence. The X-axis in the graph describes the bp location. In the lower panel, reference and comparison sequences are switched to identify regions that are absent in the reference sequence. Figure S3. LASTZ alignment of p537-20_1 (CP091535) and pECOS88 (CU928146). Table S1. Sequencing and assembly statistics.

Zusammenfassung Zecken sind Überträger einer Vielzahl humanpathogener Krankheitserreger mit einer großen Bandbreite klinischer Symptome. Das Verbreitungsgebiet der einzelnen Erreger ist vom Vorkommen der Vektoren und Wirte abhängig. Aufgrund verschiedener Faktoren ist es in den letzten Jahren zum Teil zu einer Ausdehnung der Endemiegebiete gekommen. Am weitesten verbreitet sind Zecken-übertragene Rickettsiosen, welche v.a. in der Reisemedizin eine Rolle spielen. Die häufigsten Zecken-übertragbaren Erkrankungen in Deutschland und Europa sind Lyme-Borreliose und Frühsommer-Meningoenzephalitis (FSME). Meist verlaufen die Infektionen mild oder sind — im Falle bakterieller Infektionen — gut behandelbar. Die wichtigsten präventiven Maßnahmen bei Aufenthalten in einem Risikogebiet sind der Schutz vor Zeckenstichen und im Falle der FSME die sehr gut wirksame Impfung.