The patient is a 51-year-old male who presents to the ED with a complaint of severe abdominal pain and cramping of 8 hours duration associated with diaphoresis, low-grade fevers, and anorexia. According to the patient, his symptoms began approximately 1 hour after suffering a scrotal bite from “some insect” while trying on a pair of boxer shorts his wife had just given him for Valentine’s Day.

The patient is a 27-year-old stock exchange worker who presents to the ED with a complaint of anxiety, chest pain, sweating, palpitations and a feeling of “paranoia and impending doom” following the recreational ingestion of “bath salts” two hours prior at a company party.

Indigenous to Mexico and Central America, the red green poinsettia (or Christmas Star), was first introduced to the US in the 1800s. The plant’s reputation for toxicity stemmed from a single unconfirmed case fatality of a 2-year-old child in the early 1900s.

The patient is a 21-year-old male who presents to your ED with vomiting and dizziness after drinking homemade tea made with leaves and flowers from the plant pictured.