Food Confusion Between Edible and Poisonous Plants: A 22-Year Retrospective of the Southeastern France Poison Control Center.

Objective: In some regions of the globe, accidental food confusion regarding plants can cause severe poisoning events and deaths. The aim of this study was to report on those confusions from the Marseille Poison Control Centre's (PCC) experience from 2002 to 2023.

Results: Over 22 years, 2197 food confusion events were managed with 321 different species. The most frequently involved plant was Nerium oleander (289 cases, 13.1%), then Cucurbitaceae genus (3.3%), Colchicum autumnale (3.3%), Prunus amygdalus (3%), Mahinot esculenta (3%), Cytisus laburnum (2.6%), Aesculus hippocastanum (2.5%) and Narcissus Jonquilla (2%). Many botanical confusion events were also reported (n = 1386, 63%), but with fewer than five identical species. Only one death was reported for this review, in an event involving Aconitum napellus. Two antidotes were used for all the series: Datura genus and Prunus dulcis.

Discussion: The most implicated plant was Nerium oleander. This is explained by its distribution. This rate is very low compared to that of suicide attempts with this plant. Many cases were symptomatic (53.6%), but very few of them described severe symptoms (only 0.5% severe poisonings). Few patients needed to be admitted to intensive care (0.4%), and even fewer needed an antidote (two cases). Only one death occurred, involving Aconitum napellus. Food confusions were more common than suicide attempts with plants, but seem to be less severe. However, death and serious complications can occur, so it is important to identify and manage the plants concerned.

Material and methods: For each food confusion event managed between 2002 and 2023 at the Southeastern France PCC based in Marseille, we performed a retrospective review. This PCC is responsible for the Provence-Alpes-Côte d'Azur Region, Corsica Island and Indian Ocean French overseas territories. For each case, severity was calculated with the Poison Severity Score (PSS).