Grayanotoxin poisoning following fresh rhododendron flower ingestion: a rare case report from rural Nepal.

BACKGROUND: Rhododendron, the national flower of Nepal, is widely used for culinary and traditional medicinal purposes. However, certain species, including Rhododendron decorum, contain grayanotoxins known to cause potentially life-threatening toxicity. Toxicity following fresh flower consumption has not been reported. CASE PRESENTATION: We report the case of a 58-year-old man who presented with dizziness, headache, nausea and vomiting following the ingestion of four fresh white Rhododendron flowers during a high-altitude visit to Kalinchowk, Nepal. Examination findings revealed hypotension and bradycardia. Supportive treatment with intravenous fluids led to hemodynamic stabilization. On the second day of admission, the patient experienced transient cerebellar symptoms, which resolved without specific intervention. He recovered fully within 48 h. CONCLUSION: While the prognosis is generally favorable with supportive care, recognition of characteristic symptoms is essential. This case highlights the risk of Rhododendron toxicity following ingestion of its flowers, even in small amounts. Public education and clinician awareness are crucial to prevent and manage such toxic exposures effectively.