Ricin (cont.)

Medical Author:

Ferdinando L Mirarchi, DO

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Diagnosing an aerosolized attack or a food and water contaminant with ricin primarily depends on symptoms and the likelihood of such an exposure. In cases of an isolated ricin injection, diagnosis is extremely difficult. In addition, diagnostic testing is of limited value, because there are no definitive, widely available medical tests that can confirm ricin exposure. Nonetheless, in the case of possible exposure to ricin, the patient will most likely undergo a complete physical examination by a doctor. Sophisticated diagnostic tests (not widely available) can identify ricin in the body up to 24 hours after exposure.

• If exposure is from an inhaled aerosol, the symptoms are similar to a sudden, rapidly worsening lung injury. The most common findings include labored breathing or difficulty in breathing, tightness in the chest, and rapid heart rate. A chest X-ray film shows excess fluid in the lungs.
• If exposure is through ingestion, the physical findings are usually confined to the GI tract. Symptoms include abdominal pain, vomiting, and diarrhea. Dehydration is common. If the dose was sufficient and the disease has progressed, vomiting blood or passing bloody diarrhea or dark-colored tarry stools may occur.
• If exposure is from an injection, the skin at the injection site is examined for swelling and redness. The affected area may feel painful. The skin is also examined for the possibility of a retained foreign object. The physical findings on the skin from injected ricin may occur prior to or at the time of other flulike symptoms.

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