The Solanaceae plant family (Solanum), such as capsicum, eggplant, potato, and tomato, is made up of common plants consumed by humans. Despite having medicinal benefits, these plants can produce toxic alkaloid compounds. We report 2 cases of uncommon Solanum erianthum poisoning after consuming the berries as a meal. Both patients presented with slurring of speech, which is easily mistaken for a stroke. Symptoms developed 19 h after consuming the wild berries and resolved spontaneously 12 h after onset. Both patients recovered with no neurologic deficit. No antidote was given in either case. The Solanaceae plant family is a common group of plants consumed by humans and is considered one of the largest genera. The phytochemical profile showed that the leaves and berries contain toxic glycoalkaloid levels, which can cause gastrointestinal and neurologic symptoms in poisoning cases. Reports have shown that the toxic glycoalkaloids can inhibit the cholinesterase enzyme, thus producing cholinergic effects. Theoretically, atropine is the choice of antidote, but no case report of atropine use has been documented. Treatment of S erianthum poisoning remains supportive care. These cases highlight the rare occurrence of poisoning from S erianthum and emphasize the necessity for considering toxicologic causes in nonlocalizing neurologic symptoms.
Snake-related injury (SRI) is one of the most common medical emergencies encountered in tropical countries such as Malaysia. The majority of snake bites are nonvenomous, while the less common venomous snakebite can cause major disability or even death. There are 16 pit viper species documented in Malaysia which can be categorized based on their habitat. We report a case of a 41-year-old male who presented to a district hospital 1 h after being bitten twice by a pit viper snake (Trimeresurus sabahi fucatus) on the left side of his face. He was given green pit viper anti-venom (GPAV). He later underwent an emergency tracheostomy due to progressive local swelling causing upper airway obstruction and required a second regime of antivenom. In our opinion, early recognition of snake species, clinical syndrome, and life-threatening conditions in patients with SRI is important. While careful clinical, laboratory, and patient observation is important in determining the need for anti-venom, a life-saving procedure such as intubation, in this case, should not be delayed. From our experience, SRI at the head with progressive swelling to zone 2 of the neck may signal a red flag to the attending clinician for the possibility of impending upper airway obstruction.