Three cases of aconite root poisoning due to Bikhama in a Hong Kong Nepalese family

Aconite is one of the most toxic plants. Aconite is used by herbalists for pain relief. Toxicity occurs due to misidentification, contamination, adulteration and mis-processing. Patients usually present with classical symptoms of aconite poisoning such as perioral paraesthesia, gastrointestinal upset, and generalised burning sensation. Cardiac manifestations include hypotension and ventricular tachycardia. Since aconite is a lifethreatening herb commonly used in all cultures, every clinician should be aware of this poison. This report recorded three cases of aconite poisoning in a Nepalese family who were managed in a major urban hospital in Hong Kong. They all presented with variable severity of aconite poisoning after mistakenly ingesting aconite. Management was performed basing on the clinical features, as laboratory confirmation of aconite poisoning was not immediately available. All three patients survived and did not suffer from any consequences. (Hong Kong j.emerg.med. 2010;17:158-162)