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Ricin
From WikEM
Contents
Background
- Found in castor beans from the plant Ricinus communis
- A residual product of the production of castor oil (if properly prepared, does not contain the toxin)
- Exposure can be parenteral, inhaled, or ingested
Clinical Features
- First symptoms occur 3-12 hours after exposure
- Acute lung injury
- Fever, cough, shortness of breath, and nausea
- Death 36-48 hours after exposure
- Alveolar flooding, fibropurulent pneumonia, and necrotizing tracheitis
Differential Diagnosis
Pulmonary Edema Types
Cardiogenic pulmonary edema
Noncardiogenic pulmonary edema
- Negative pressure pulmonary edema
- Upper airway obstruction
- Reexpansion edema
- Neurogenic causes
- Iatrogenic fluid overload
- Multiple blood transfusions
- IV fluid
- Inhalation injury
- Pulmonary contusion
- Aspiration pneumonia and pneumonitis
- Other
Bioterrorism Agents[1]
Category A
Category B
- Ricin
- Brucellosis
- Epsilon toxin
- Psittacosis
- Q Fever
- Staph enterotoxin B
- Typhus
- Glanders
- Melioidosis
- Food safety threats
- Water safety threats
- Viral encephalitis
Category C
- Influenza
- Yellow fever
- Tickborne hemorrhagic fever
- Tickborne encephalitis
Evaluation
- Chest x-ray = bilateral infiltrates (pulmonary edema)
- Multi-organ failure occurred with a prominently elevated white blood cell count
Management
- Supportive
Disposition
- Admit
See Also
External Links
References
Authors
Ross Donaldson, Michael Holtz, Kevin Lu, Daniel Ostermayer, Neil Young
