II. Background

  1. Araceae family of plants
  2. Genera include Alocasia, Arisaema, Caladium, Colocasia, Dieffenbachia, and Philodendron
  3. Broad firm and shiny leaves
  4. Examples
    1. Mother-In-Law's Tongue (Dracaena trifasciata)
    2. Elephant Ears (genera Colocasia, Alocasia, and Xanthosoma)

III. Mechanism

  1. Plant is coated in sharp, lancinating Calcium oxalate crystals (raphides)
  2. When the plant is bitten (most often by a child), the crystals lance the mucosa causing localized symptoms

IV. Symptoms

  1. Pain and swelling of mucosa on biting leaf

V. Signs

  1. Crying due to pain
  2. Drooling
  3. Anterior oropharyngeal swelling (esp. lips, Tongue)
  4. Tongue Pain may interfere with speaking

VI. Differential Diagnosis

  1. See Plant Toxicity
  2. Anaphylaxis
  3. Angioedema

VII. Management

  1. Airway Management as needed
    1. Case reports of posterior oropharyngeal involvement and need for Endotracheal Intubation
  2. Typically self limited and resolves in 20-30 minutes
  3. Treated symptomatically
    1. Cold milk
    2. Popsicles

VIII. References

  1. Claudius, Behar and Nordt in Herbert (2020) EM:Rap 20(9): 5-7

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