Intoxication by ingestion of castor beans

A 77-year-old woman was brought to the emergency room and subsequently admitted to the ICU for treatment of a mixed intoxication including 15 crushed castor beans, which she obtained from a reform store and ingested in a suicide attempt. The patient suffered from severe vomiting and diarrhoea, complicated by renal dysfunction and aspiration pneumonia. Symptomatic treatment of the pneumonia with antibiotics, nebulised bronchodilators and oxygen supply allowed the patient to recover somatically. After three days in the ICU, she was discharged to the department of internal medicine, and agreed to be admitted to the psychiatric department another three days later. No symptoms of the intoxication remained at that time. Castor beans are the seeds of the castor bean plant, containing the highly toxic compound ricin. If an intoxication with castor beans is suspected, it can only be treated symptomatically since no antidote is available. Treatment should focus on gastrointestinal effects and possible mid-term hepatic damage.