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4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Treatment Details

Ergot

Ergot is the dried sclerotinum of the fungus Claviceps purpurea, which grows on cereals like rye, barley, wheat, oats, etc. It gradually replaces the grain forming a curved, dark-purple or black compact mass, 0.9 to 1 cm long, half cm thick, with lengthwise ridges, and has a peculiar odour and a disagreeable taste. It contains about 30 alkaloids, but ergotoxine, ergotamine and erogometrine{ecbolics} are important.

Route : Ingestion

Fatal dose : 2 to 10 g.

Fatal Period : One to several days

Mechanism of action : Ergot alkaloids exert their primary effect by stimulating adrenergic receptors, both peripherally and centrally. They directly stimulate muscle fibres.

Clinical picture : In acute cases, nausea, vomiting, diarrhoea, giddiness, tightness in the chest, difficulty in breathing, marked muscular weakness and exhaustion. There may be tingling and numbness in the hands and feet, paraesthesias, followed by twitching or cramps in the muscles. Bleeding from the nose and other mucous surfaces is common after large doses. The pulse is rapid and weak, pupils are dilated with dimness of vision, blood pressure is raised.

Chronic Poisoning {Ergotism}:
There is tingling and numbness of the skin` vasomotor disturbances leading to dry gangrene of the fingers, toes, ears, nose, etc. There is a sensation of insects creeping under the skin. Neurologic disorder characterised by hallucinations, ataxia, and convulsions may occur.

Treatment : 1. Wash the stomach
2. Activated charcoal
3. Syrup of ipecac
4. Cathartics
5. Nitroprusside for hypertension and severe ischemic changes
6. Diazepam 0.1mg, kg i.v. slowly for convulsions
7. Vasodilators e.g. nitrites are useful

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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