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Chapter 17
Botanical Encounters
Recommendations are considered Category 1B, except where indicated 1A, by the WMS
Panel of Expert Reviewers
I. GENERAL INFORMATION
The majority of botanical problems in humans are due to contact but some are due to
ingestion, mostly of fungi. Treatment in the field depends on the nature and severity of
the problem. Many contact episodes can be treated on the spot. Virtually all contacts by
ingestion require urgent evacuation.
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II. PLANT-INDUCED DERMATITIS
Most injuries result from simple mechanical or chemical trauma, sensitization to
allergens or a photochemical response. Dermal reactions may be immunologic,
nonimmunologic or both. Injuries may be further complicated by secondary infections, id
reactions and further damage by excoriation or improper treatment. Identification of the
offending plant is important to both treatment and future avoidance.
A. Mechanical Injury and Treatment
Many plants possess spines, thorns, bristles, barbs and sharp serrated edges, contact with
which can cause punctures or lacerations that often contain embedded plant material.
Other plants contain specialized structures to deliver irritants that cause both mechanical
and chemical injury. Numerous spines, thorns and fine hairs, called glochids, in the
cactus genus Opuntia can cause aseptic granulomatous lesions resembling scabies.
Follow basic wound care principles when treating punctures and lacerations.
Clean all wounds and remove any foreign material. Apply, then carefully remove, glue
or tape to extract fine foreign bodies, though tape stripping was associated with increased
cactus spine persistence and more inflammation in at least one experimental study
(Recommendation 1A) (Martinez TT, Jerome M, Barry RC, Xander JG. Removal of
cactus spines from the skin. A comparative evaluation of several methods. Am J Dis
Child. 14:1291-2, 1987). Applying a topical steroid after spine removal may decrease
inflammation..
Deeply embedded material must be excised to avoid serious complications such
as osteoblastic and osteolytic changes in bone, synovitis in joints and localized or
generalized infections. If removal is not possible in a remote location, the victim must be
transported for definitive care. Provide pain control as necessary and if definitive care
cannot be reached within 2-3 days initiate antibiotic prophylaxis as soon as possible to
reduce the chance of infection. Most infections will be caused by dermatologic organisms
and are usually well covered by first generation cephalosporins. Augmented pencillins,
fluoroquinolones and macrolide antibiotics are alternatives.
