No abstract

Background: Case reports of black locust tree (Robinia pseudoacacia L.) bark ingestions are scarce in modern medical literature. The black locust tree is native to the Appalachian Mountains as well as parts of the Midwestern United States. The seeds and bark of the tree are known to be toxic when ingested. Since oral absorption of the toxins is limited; symptoms are primarily gastrointestinal in nature.Case Report: A twelve-year-old male presented with weakness, nausea, vomiting and diarrhea after ingestion of black locust tree bark. Pertinent vital signs and laboratory results include a temperature of 101.5°F, a heart rate of133 beats per minute, pH of 7.31, a White Blood Cell (WBC) count of 25.6 x 10 3 cells/L, a hematocrit of 50.1%, and an alkaline phosphatase of 216 U/L. Intravenous ondansetron and fluids had been administered at a referring hospital. He was transferred to our facility where he was admitted for observation and did not experience any additional episodes of emesis or diarrhea. Due to the early recognition of the etiology of his symptoms, no further workup was required and the patient was discharged home in stable condition after tolerating a liquid diet the next day. Conclusion:Ingestion of black locust tree bark can result in clinical toxicity with primarily gastrointestinal symptoms. Supportive care with appropriate medical observation is the mainstay of treatment and generally results in positive outcomes. The effectiveness of gastric decontamination by activated charcoal is unknown but a single dose may be considered if the patient presents within one hour of ingestion without contraindications.