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HOME > J Korean Soc Clin Toxicol > Volume 17(2); 2019 > Article
A Case of Green Tobacco Sickness (GTS) in Elderly Patient
Dong Kil Jeong, Doh-Eui Kim
Journal of The Korean Society of Clinical Toxicology 2019;17(2):132-134
Published online: December 31, 2019
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1Department of Emergency Medicine, Taean-Gun Health Center
2Department of Emergency Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital

Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.

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JKSCT : Journal of The Korean Society of Clinical Toxicology