Generation #Foodporn #Foodpornsaveslives

Background: Today, up to approximately 65% of all 13- to 30-year olds photograph their food and post it on social networks, and this habit is called “food porn.” The yew-intoxication (Taxus baccata) is caused by the alkaloid taxin B as an ingredient mainly in the leaves. The effects usually present as severe refractory cardiac arrhythmias, which can be fatal or often result in prolonged resuscitation or require ECMO therapy. The rapid use of digoxin-specific Fab antibody fragments seems to be the most promising approach when the causative agent is known, as the proarrhythmogenic effect of toxins can be reduced by crossreaction of antibodies with taxanes.

Case Report: The 16-year-old boy prepared a smoothie using unknown fruits and leaves to change his eating habits to a healthier food and reduce weight. A few hours later, nausea, dizziness, and vomiting occurred. The emergency ambulance team diagnosed a VT with an HR of 180 bpm, which persisted despite fractionated administration of 450 mg amiodarone and three trials of cardioversion. Due to intermittent bradycardia, a short period of resuscitation was necessary with rapid ROSC; however VT persisted. On admission, the patient was nearly unconscious with a GCS of 7 and hemodynamically unstable with heartrates from 45 to 150 bpm, with limited ejection fraction and ongoing ventricular tachycardia. Amiodarone infusion resulted in repetitive bradycardias with a minimum heart rate of 27 bpm with sustained VT. The further medical history by the father revealed that the patient had photographed his food and it turned out that it was Yew plants. Thereafter treatment with digoxin-specific Fab antibody fragments was initiated. The rhythm quickly stabilized within the next few hours, the broad QRS complexes narrowed and after 12 hours the patient regained normal sinus rhythm. After 3 days of monitoring, the patient was able to be discharged home without complications.

Discussion: The refractory VT, which responded neither to electrical therapy nor to any drug interventions, ultimately manifested itself as an acute yew-intoxication. The main toxicity is based on that in Taxus spp. containing alkaloid taxin B with massive cardiotoxic effect.

Conclusion: Only the rapid identification of the intoxication with the help of the photographs enabled a targeted therapy, which in the end could stabilize the rhythm. In our case, it can therefore be summarized that the habits of the generation #foodporn has saved the patient’s life.