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08-30-16 School Is In Session: Can Plants Be a Problem?

Question of the Week

School Is In Session: Can Plants Be a Problem?

August 30, 2016

Children are very curious about the world surrounding them and tend to be oral explorers . This could be a concern for children starting daycare or preschool. Plants are a most commonly a choking hazard, sometimes causing nausea and vomiting, or mild oral and throat irritation. The majority of the time very little of the plant is ingested, causing very mild symptoms.

The most common houseplants are dieffenbachia and philodendron. These plants contain oxalate crystals which can irritate the mouth and throat, causing swelling of the lips, tongue, and in severe cases, the oropharynx; Other house or office plants include the rubber tree, pothos, schefflera and mother-in-laws tongue which can cause dermatitis and blistering. Most ingestions are mildly irritating and require a cold drink or snack at home. Patients with airway swelling or difficulty breathing should seek medical attention.

During recess children may have more access to naturally growing plants such as pokeweed and holly bushes. Pokeweed has a thick purple stalk with dark purple berries. These berries stain fingers purple. If enough berries are ingested, these can cause stomach upset with nausea and diarrhea. Holly bushes have bright red berries which are attractive to children. These berries will also cause some GI distress if several are ingested. Serious effects are not typically expected.

Oleander, lily of the valley, and foxglove are cardiac glycosides that can cause cardiac dysrhythmias. Cardiac glycosides have effects comparable to digoxin. Small ingestions are unlikely to cause any issues, but large purposeful ingestions may need medical attention and observation.

There are many hallucinogenic plants. One of the more commonly available and more recognizable plants in this category is jimson weed. It contains anticholinergic alkaloids. Patients present clinically like a diphenhydramine overdose exhibiting an anticholinergic toxidrome as discussed in the last Question of the Week. Although less common, salvia, currently popular in pop-culture, is also smoked for hallucinogenic effects.

Are there any plants that you should recommend that parents avoid planting in the yard or having in the house? No, children explore and may taste in such small quantities that symptoms are typically self-limited and mild. If you have questions or are treating a symptomatic patient, please call the Poison Center to speak with one of our Specialists in Poison Information at 1-800-222-1222.

This question prepared by: Denese Britt, BSN, MS, CSPI (Certified Specialist in Poison Information) Tennessee Poison Center