Clinical analysis of Rhododendron decorum Franch. flower poisoning in Northeast Yunnan

To analyze poisoning cases from consuming Rhododendron decorum Franch. flowers (RDf) in Northeast Yunnan, documenting symptoms, lab test results, medical interventions, and outcomes. This retrospective observational study documented 15 cases of RDf poisoning, detailing symptoms, physical examinations, lab test results, and medical interventions. Statistical analysis was conducted using SPSS 29. Of the 15 patients, the majority were male (66.67%), with an average age of 46.73 ± 13.42 years. The average onset time of symptoms was 2.17 ± 0.99 hours, typically appearing after consuming 98 ± 62.13 grams(median 80 g, IQR 60–120 g) of RDf. Common symptoms included dizziness (93.33%), nausea (66.67%), and fatigue (60%). 13 exhibited sinus bradycardia (86.67%), 2 showed junctional escape beats (13.33%), 1 presented with Wolff-Parkinson-White syndrome (WPW) (6.67%), 1 showed right bundle branch block (6.67%), and 1 had sinus arrest (6.67%). No statistically significant correlation was observed between the amount of RDf intake and heart rate, systolic blood pressure, or diastolic blood pressure. Most patients recovered within 6 hours, and no fatalities occurred. Laboratory tests revealed no significant abnormalities, and the primary treatments were fluid therapy and gastric irrigation. Based on our analysis, the following recommendations are made: 1. In northeastern Yunnan, especially in the emergency department, inquiring about a patient's food history in the setting of severe drops in heart rate and blood pressure is crucial. If RDf consumption is identified and there is no history of heart disease, further extensive cardiac investigations may not be required after an adequate period of observation and confirmation of clinical stability. However, close monitoring of heart rate and blood pressure during the acute phase remains essential due to the potential for cardiovascular instability. 2. Blanching and thorough repeated soaking may reduce grayanotoxins (GTX) content in RDf. 3. For RDf poisoning, gastric irrigation and appropriate fluid therapy are feasible, but the use of atropine requires comprehensive clinical evaluation.