Chinaberry Melia azedarach

Chinaberry (Melia azedarach) is a tree with serrated leaves, long leaflets, and scented, purple flowers arranged in clusters. The toxic agent is concentrated in the berries that are yellow, contain smooth black seeds, and persist after the leaves are shed. Chinaberry trees grow in the South from Florida to Hawaii. Ingestion of as few as six to eight berries has been reported to cause fatalities (8).

In patients who ingest the berries, a prolonged latency period is followed by development of mental confusion, ataxia, dizziness, and stupor. Some patients may develop intense vomiting and bloody diarrhea, which results in hypovolemic shock. Respiratory depression, seizures, and paralysis also have been reported (8).

The treatment is primarily symptomatic in nature. Gastric decontamination may benefit by reducing the absorbed dose. Benzodiazepines remain the mainstay of management of seizures induced by plant alkaloids.

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