![]() 4 Despite the high number of plants cultivated, between 20 only eleven events of human exposure to members of these genera were reported to the Hawai‘i Poison Center, out of the total 44 anticholinergic plant exposures that were reported. Brusmansia x candida, one of the many Brugmansia plants commonly referred to Angel's trumpet,is the most commonly cultivated species within this genus. 3 There continues to be confusion regarding what genus member plants belong to therefore, case reports and poison control reports of contamination and ingestion interchange the genera. Lockwood separated the genus Datura into two sub-genera: Datura and Brusmansia. 2 The Datura and Brusmansia genera of plants are often used interchangeably due to all member plants initially being included in the genus Datura. The first Angel's trumpet plant, at that time listed as Datura arborea, was brought to Hawai‘i in 1825, aboard the HMS Blonde. Although eye contamination with the Angel's trumpet plant is self-limited and resolves within a week, the appearance of a persistently unilateral mydriatic eye can be alarming to patients and clinicians, which too often results in an unnecessary, costly workup. It is critical when obtaining a history from a patient with such a presentation to ask explicitly about any contact with plants prior to onset of symptoms. This likely explains why even brief contact with the plant can result in unintentional contamination of the eye and in mydriasis. The three active components occur in different parts of the plant, including on the small glandular hairs that cover the entire plant. The Angel's trumpet plant contains three active components which can result in mydriasis: hycosamine, atropine, and scopolamine. We report the case of a 14-year-old girl who presented to the pediatric emergency department with acute anisocoria and unilateral mydriasis after contacting an Angel's trumpet plant and who had complete resolution of symptoms four days following eye contamination. ![]() Acute anisocoria and unilateral mydriasis is physically alarming to patients and diagnostically worrisome to clinicians.
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