Acute Oleander Poisoning After a Self-Prepared Tisane (Letter)

A case of acute oleander poisoning was recently observed in our Emergency Department in a middle-aged woman who showed severe signs of digitalis toxicity. The patient drank an oleander and lime blossom tea prepared by herself for sedative purpose, as suggested by an herbal magazine. Two hours later she manifested nausea, vomiting, diarrhea, and severe weakness. The electrocardiogram showed a third-degree atrioventricular block with a short QRS. Serum digitalis was 4.2 ng/dL and potassium 8.8 mEq/L. After hydration the symptoms and the electrocardiographic alterations quickly reversed and the patient was discharged four days later after full recovery. Treatment with digoxin fragments was not thought necessary. The case of our patient again warns of the risk of natural preparations having potentially toxic effects.