Mixed intoxication with Aconitum nappellans (monkshood) and Digitalis grandiflora (large yellow foxglove).

BACKGROUND

Intoxications are frequent and relevant medical problems in emergency units.

METHODS

We report of a mixed intoxication with monkshood and large yellow foxglove. A 39-year-old mentally ill drug addict, intent on committing suicide, swallowed an undefined amount of chaffed monkshood and large yellow foxglove. The typical symptoms of an intoxication occurred, including high-grade ventricular and supraventricular tachyarrhythmias, colic abdominal pain, and peripheral paralysis. After activated charcoal was repeatedly administered as well as FAB digitalis-antibodies, a lasting normalisation of the heart rhythm set in and a release of the clinical symptoms could be observed.

CONCLUSIONS

FAB antibodies are a safe antidote for herbal digitalis intoxication. Therapy of choice for an aconitum poisoning is activated charcoal and intensive monitoring.