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. 2021 Jan;27(1):278-280.
doi: 10.3201/eid2701.202222.

Fatal 3-Nitropropionic Acid Poisoning after Consuming Coconut Water

Thomas Birkelund, Rakel F Johansen, Dorte G Illum, Stig Eric Dyrskog, Jakob A Østergaard, Travis M Falconer, Chris Andersen, Helena Fridholm, Søren Overballe-Petersen, Jørgen S Jensen

Fatal 3-Nitropropionic Acid Poisoning after Consuming Coconut Water

Thomas Birkelund et al. Emerg Infect Dis. 2021 Jan.

Abstract

We describe the fatal course of a patient with initial symptoms of vomiting and nausea who developed symptoms of dystonia, encephalopathy, and coma. The cause of death was poisoning with 3-nitropropionic acid from coconut water spoiled with the fungus Arthrinium saccharicola. We present the clinical findings and forensic analysis.

Keywords: 3-nitropropionic acid; Arthrinium saccharicola; coconut; fungi; poisoning.

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Figures

Figure
Figure
The type of ecologically grown coconut involved in the case of a 69-year old Caucasian man in Aarhus, Denmark, who died of poisoning with 3-nitropropionic acid from coconut water spoiled with the fungus Arthrinium saccharicola. The coconut was commercially prepared, including removal of the husk, and was sold as ready-to-drink, with an included punch and straw for easy access to the carpels (holes) and the coconut water.
See this image and copyright information in PMC

References

    1. Anwar M, Kasper A, Steck AR, Schier JG. Bongkrekic acid—a review of a lesser-known mitochondrial toxin. J Med Toxicol. 2017;13:173–9. 10.1007/s13181-016-0577-1 - DOI - PMC - PubMed
    1. Ibrahim AS, Gebremariam T, Liu M, Chamilos G, Kontoyiannis D, Mink R, et al. Bacterial endosymbiosis is widely present among zygomycetes but does not contribute to the pathogenesis of mucormycosis. J Infect Dis. 2008;198:1083–90. 10.1086/591461 - DOI - PMC - PubMed
    1. Krogsgaard LR, Andersen LO, Johannesen TB, Engsbro AL, Stensvold CR, Nielsen HV, et al. Characteristics of the bacterial microbiome in association with common intestinal parasites in irritable bowel syndrome. Clin Transl Gastroenterol. 2018;9:161. 10.1038/s41424-018-0027-2 - DOI - PMC - PubMed
    1. Clode FE, Kaufmann ME, Malnick H, Pitt TL. Evaluation of three oligonucleotide primer sets in PCR for the identification of Burkholderia cepacia and their differentiation from Burkholderia gladioli. J Clin Pathol. 1999;52:173–6. 10.1136/jcp.52.3.173 - DOI - PMC - PubMed
    1. Falconer TM, Kern SE, Brzezinski JL, Turner JA, Boyd BL, Litzau JJ. Identification of the potent toxin bongkrekic acid in a traditional African beverage linked to a fatal outbreak. Forensic Sci Int. 2017;270:e5–11. 10.1016/j.forsciint.2016.10.015 - DOI - PubMed

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