Margosa (Kohomba) oil induced toxic encephalopathy following home remedy for intestinal worms.

Correspondence: MPS, e-mail . Received 30 March 2009 and revised version accepted 16 July 2009. Competing interests: none declared. Margosa oil induced toxic encephalopathy is a recognised entity [1]. It presents with vomiting which begins minutes to hours after ingestion, followed by drowsiness and generalised seizures. Hepatomegaly, elevated liver enzymes, metabolic acidosis and leukocytosis resembling Reye-like illness occur in children following margosa oil ingestion [2, 3]. The majority recover completely with symptomatic treatment with anticonvulsants and intravenous bicarbonate, but fatalities have been reported. Autopsy findings are fatty infiltration of the liver with mitochondrial damage and cerebral oedema [4].