Journal article
Poisoning from “Spanish fly” (cantharidin)
American Journal of Emergency Medicine, v 14(5), pp 478-483
01 Sep 1996
PMID: 8765116
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Cantharidin, known popularly as Spanish fly, has been used for millennia as a sexual stimulant. The chemical is derived from blister beetles and is notable for its vesicant properties. While most commonly available preparations of Spanish fly contain cantharidin in negligible amounts, if at all, the chemical is available illicitly in concentrations capable of causing severe toxicity. Symptoms of cantharidin poisoning include burning of the mouth, dysphagia, nausea, hematemesis, gross hematuria, and dysuria. Mucosal erosion and hemorrhage is seen in the upper gastrointestinal (GI) tract. Renal dysfunction is common and related to acute tubular necrosis and glomerular destruction. Priapism, seizures, and cardiac abnormalities are less commonly seen. We report four cases of cantharidin poisoning presenting to our emergency department with complaints of dysuria and dark urine. Three patients had abdominal pain, one had flank pain, and the one woman had vaginal bleeding. Three had hematuria and two had occult rectal bleeding. Low-grade disseminated intravascular coagulation, not previously associated with cantharidin poisoning, was noted in two patients. Management of cantharidin poisoning is supportive. Given the widespread availability of Spanish fly, its reputation as an aphrodisiac, and the fact that ingestion is frequently unwitting, cantharidin poisoning may be a more common cause of morbidity than is generally recognized. Cantharidin poisoning should be suspected in any patient presenting with unexplained hematuria or with GI hemorrhage associated with diffuse injury of the upper GI tract.
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Details
- Title
- Poisoning from “Spanish fly” (cantharidin)
- Creators
- David J Karras - From the Division of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA. USASusan E Farrell - Drexel UniversityRichard A Harrigan - Temple UniversityFrederick M Henretig - Children's Hospital of PhiladelphiaLaura Gealt - Children's Hospital of Philadelphia
- Publication Details
- American Journal of Emergency Medicine, v 14(5), pp 478-483
- Publisher
- Elsevier
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002)
- Web of Science ID
- WOS:A1996VC54300014
- Scopus ID
- 2-s2.0-0029742794
- Other Identifier
- 991021867243504721
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- Web of Science research areas
- Emergency Medicine