A 19-year-old student is brought to the emergency department after eating wild seeds offered by a stranger. He is agitated, flushed, and disoriented. Examination shows dilated pupils that do not react to light, dry skin and mucous membranes, tachycardia, temperature 39 degrees C, and urinary retention. Which substance is the most likely cause?

• A Dhatura (Datura stramonium) seeds ✓
• B Organophosphorus insecticide
• C Aconite root
• D Strychnos nux-vomica seeds

Explanation

The classic anticholinergic toxidrome of Dhatura poisoning includes mydriasis with absent light reflex, dry hot skin, flushed face, tachycardia, hyperthermia, delirium, and urinary retention. Organophosphorus poisoning shows the exact opposite with miosis and secretions, which kills distractor B. Aconite causes perioral numbness and ventricular arrhythmias without anticholinergic signs, and strychnine produces convulsions with full consciousness.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.