Unexpected Double Lethal Oleander Poisoning

Nerium oleander is a very popular urban ornamental plant in Europe, but it’s also extremely dangerous because it contains several types of glycosides whose accidental ingestion can cause cardiac arrhythmias and even deaths. The rarity of such cases makes it difficult to think of Oleander poisoning without evidences that suggest this possibility as a cause of unexpected death. This report concerns the discovery of the bodies of two young people, a man and a woman, found in a forest, in conditions of extreme malnutrition. The medico-legal investigations showed neither pathological nor traumatic causes of death, but it was noticed the presence of vegetal remains in the stomach. Common toxicological analysis resulted negative, but the implementation of more detailed investigations showed the presence of digoxin in the blood of both cadavers. Obviously excluding the possibility of a pharmaceutical provenience of digoxin, this laboratory result was interpreted as evidence of ingestion of Oleander, that contains oleandrine, whose cross-reaction with digoxin is widely described in literature. The identification of the two subjects, which occurred after four years, strengthened the hypothesis of accidental poisoning by Oleander as the two young people were adherents of the movement of Vegans, extreme vegetarians that reject the ingestion of foods of animal origin and live by eating only what they find in nature