Mad honey poisoning with cardiac and neural manifestation - a rare case report from Western Nepal.

Introduction: Mad honey poisoning is caused due to presence of grayanotoxin. Grayanotoxin interferes with depolarization of cardiac and nervous tissue resulting in symptoms like dizziness, bradycardia, and syncope. Here the author presents a case report of mad honey poisoning reported in Western region of Nepal. Case presentation: The author reports a case of 20-year-male with no known prior co-morbidities who accidently ingested wild honey and thereafter developed cardiac and neural symptoms like dizziness, nausea, bradycardia with multiple brief episodes of generalized tonic spasm. There was no past or family history of allergic reaction to honey or pollen. Discussion: Symptoms experienced by the patient was managed primarily in Emergency department and then further evaluation and management is done in ICU. Diagnosis was established based on the occurrence of symptoms following consumption of honey and laboratory data. No definite diagnosis of grayanotoxin can be done due to lack of commercially available detection test. Patient gets stabilized after 24 hours of supportive care in ICU. Conclusion: This case report aims at early detection of mad honey poisoning so that timely intervention can be done and further complications can be prevented. Thus, it helped in reducing morbidity and mortality mostly at the region where it is highly prevalent.