Citrullus colocynthis (bitter apple) poisoning; a case report

Citrullus colocynthis Schrad (Cucurbitaceae), commonly known as bitter apple, is a tropical plant that grows abundantly in the south of Iran, and widely in other parts of the world. It has a folklore origin and in traditional system of medicine is used as purgative, analgesic, anti-diabetic, vermifuge, abortifacient, etc.

There are few case reports about toxicity of this plant, and in this paper, we presented a 48-year old man with acute Citrullus colocynthis toxicity who was admitted to the emergency department ten hours after ingestion of decoction of plant fruit for self-treating of his constipation. He developed watery diarrhea, hypotension and hypoglycemia. Hepatic injury was also developed indicated as rising in Alanine aminotransferase(ALT) and Aspartate aminotransferase(AST) enzymes. He was treated with supportive management in the intensive care unit (ICU). All parameters reached to the point of normalcy after four days and he discharged from the hospital with full recovery.