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oa A rare encounter of mad honey intoxication in Qatar—clinical presentation, management, and implications: A case report
- Source: Qatar Medical Journal, Volume 2025, Issue 2, Jun 2025, 56
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- 20 June 2024
- 20 October 2024
- 30 June 2025
Abstract
Background: Mad honey is a unique type of honey that is contaminated with grayanotoxins. The consumption of this honey might cause poisoning, which manifests as a wide range of signs and symptoms. We report a patient with mad honey disease who presented to our Emergency Department (ED). This is the first case report of mad honey disease in Qatar.
Case presentation: A 39-year-old male Nepalese patient presented to our ED, who complained of dizziness and feeling unwell for approximately 2 hours. He was found to be hypotensive and bradycardic. The patient responded to the supportive management provided, but a few hours later, he developed hypotension, bradycardia, and first-degree atrioventricular block. Mad honey intoxication was confirmed based on the dietary history and onset of symptoms after honey consumption. Atropine and supportive treatments were continued until the patient stabilized.
Discussion: Mad honey contains grayanotoxins, which are a group of neurotoxins produced mainly by species of the Rhododendron genus within the Ericaceae family. Grayanotoxins exert their toxic effects through binding to sodium channels in cell membranes and muscarinic M2 receptors in the vagus nerve. Although mad honey poisoning is usually a benign condition, significant morbidity has been reported.
Conclusion: Although mad honey disease is rarely encountered in the Middle East, it is not unlikely to occur. Obtaining an appropriate medical and dietary history with timely recognition of the signs and symptoms of grayanotoxin poisoning could substantially improve the initiation of supportive management and minimize morbidity.