Intoxicación por anís de campo (Ocimum selloi).: A propósito de un caso

Resumen El uso de plantas medicinales en lactantes puede ocasionar cuadros graves de neurotoxicidad, constituyendo una poblacion especialmente vulnerable. Se describe el primer caso reportado en Uruguay de una intoxicacion aguda grave por ingesta de una infusion de anis de campo (Ocimum selloi) utilizado con fines medicinales. Neonato de 6 dias, que presento apnea durante higiene corporal, hipersialorrea e hipotonia generalizada de 2 minutos de duracion. En el examen clinico inicial se destaca hiporreactividad, hipotonia, bradicardia e hipotermia. Ingreso a Terapia Intensiva, constatandose elevacion de enzimas hepaticas y bradicardia sinusal. Se descartaron causas infecciosas y la valoracion metabolica fue normal. Electroencefalograma y ecocardiograma normales. Resonancia nuclear magnetica de craneo con angiografia sin alteraciones. En la anamnesis surge la administracion de infusion de anis de campo desde el dia previo. Presento buena evolucion con recuperacion de la frecuencia cardiaca y el tono a las 24 y 48 horas del ingreso, respectivamente. Este cuadro con sintomas neurologicos es una forma de presentacion frecuente en casos de neurotoxicidad por plantas que contienen aceites esenciales como Ocimum Selloi. El antecedente de exposicion a la sustancia con una clara relacion cronologica entre exposicion y aparicion del cuadro orientaron a etiologia toxica. La dosis administrada, la exposicion repetida y la inmadurez de los sistemas fisiologicos del neonato constituyen factores determinantes del cuadro de intoxicacion. Es importante advertir a las familias del riesgo de administrar hierbas medicinales en ninos pequenos.(AU) Summary Medicinal herbs used in infants may cause severe neurologic toxicity, given the fact they are a vulnerable group. We report the first case of severe acute poisoning by ingestion of a green pepper basil (Ocimum selloi) infusion used with medical purposes in Uruguay. Six day-old newborn who presented cessation of breathing during body bath associated with hypersalivation and general hypotonia lasting about 2 minutes. Initial clinical presentation included hyporeactivity, hypotonia, bradycardia and hypothermia. He was admitted to the Intensive Care Unit, where increased hepatic enzymes levels and synus bradicardia were found. Infectious screening was negative and metabolic assessment was normal. There were no alterations in electroencephalogram, echocardiogram and cranial magnetic resonance imaging. The neonate had been given a green pepper basil infusion one day before admission to the ICU. His medical condition improved with normal heart rate in the first 24 hours, and normal neurologic examination was observed 48 hours after admission. Neurological findings represent a frequent clinical presentation in cases of plants neurotoxicity containing essentials oils as Ocimum selloi. A toxic cause was suspected after a history of substance exposure with a chronological association between herb administration and symptoms onset. Administrated dose, repetitive exposure and newborn physiological immaturity became determining factors in the development of this reported situation. It is important to talk to families about the risk of medicinal herbs administration in infants.(AU)