Wild (Mad) Honey Poisoning: A Case Report from Nepal
Abstract
Aashish Neupane*, Gyaneswhor Shrestha, Amrit Neupane, Purushottam Neupane and Bishal Thapa Magar
Introduction and Importance: Ingestion of honey that has a toxin called as grayanotoxin causes wild or mad honey poisoning. This can lead to nausea, vomiting, dizziness, sweating, altered consciousness, hypotension, bradycardia, cardiac rhythm abnormalities like first-, second-, and third -degree AV block, asystole and sinus bradycardia.
Case History: A 40 years old man presented to emergency room with complaints of multiple episodes of vomiting, dizziness, impaired consciousness for 30 minutes following consumption of wild honey with low blood pressure and pulse rate. He was treated with IV fluids and intravenous atropine with no complications.
Discussion: Consumption of wild honey made by bees from few species of rhododendron like Rhododendron luteum, R. Ponticum, R. Simsii leads to wild (mad) honey poisoning. Wild honey is considered as alternative medicine in treatment of hypertension, acid peptic disease, arthritis, sexual dysfunction, coronary artery disease, diabetes and bowel disorder. Grayanotoxin increases sodium channel permeability by attaching to sodium channels on the cell membrane thus inhibiting repolarization. Diagnosis requires high index of clinical suspicion and history of ingestion of honey along with symptoms is particularly important for diagnosis.
Conclusion: Wild honey poisoning is rare but can occur in specific geographical location like hilly region of Nepal. Most poisoning are not fatal and it does not last more than 24 hours thus such cases requires monitoring for 24 hours duration.