# A 20-Year Retrospective Analysis of Plant Poisoning Cases at the Naval Hospital, Varna, Bulgaria

## TL;DR

This study analyzed 20 years of plant poisoning cases in Bulgaria, finding that most were mild to severe but non-fatal, with no deaths reported.

## Contribution

The paper provides a 20-year retrospective analysis of plant poisoning cases in a single hospital, highlighting toxidrome distribution and clinical outcomes.

## Key findings

- Plant poisoning cases accounted for 0.35% of all hospitalized poisoning cases over 20 years.
- Anticholinergic, cyanogen, and ricin toxidromes were the most frequently observed.
- Most cases were unintentional and resulted in mild to severe symptoms, with no fatalities.

## Abstract

The nature and epidemiology of plant intoxications are still not well understood, with recent data being limited. The present study aims to report cases of plant poisoning in the clinical practice of the Clinical Toxicology Department at the Naval Hospital—Varna, Bulgaria, over a 20-year period (2003–2023). A documentary retrospective analysis of the hospitalized cases of poisoning with poisonous plants and their grouping into toxidromes was performed. During the study period, patients with plant poisoning admitted to our hospital unit accounted for 0.35% of a total of 12,857 hospitalized individuals. The distribution across the toxidromes based on clinical presentation revealed the highest frequency of anticholinergic, cyanogen, and ricin toxidromes. The majority of the intoxications resulted from unintentional exposure to plant toxins in adult individuals. Most cases followed a mild to severe clinical course, with patient discharge occurring between 2 and 5 days. No fatalities were recorded, thanks to the reported treatment methods. A relatively low incidence of plant-related poisonings was observed, with their predominant manifestations affecting the gastrointestinal, nervous, and cardiovascular systems. Increased reporting of epidemiological data and clinical experiences in the management of plant intoxications would substantially enhance researchers’ understanding of them and facilitate the development of a standardized treatment protocol.