Is voluntary envenomation from the kambô ritual therapeutic or toxic?

The Amazonian kambô frog Phyllomedusa bicolor (Amphibia: Phyllomedusidae): Current knowledge on biology, phylogeography, toxinology, ethnopharmacology and medical aspects

Phyllomedusa bicolor (Phyllomedusidae), popularly known as the kambô in Brazil, is a tree frog that is widely distributed in South American countries and is known for producing a skin secretion that is rich in bioactive peptides, which are often used in indigenous rituals. The biological effects of the skin secretion were observed in the first studies with indigenous communities. Over the last six decades, researchers have been studying the chemical composition in detail, as well as the potential pharmacological applications of its constituents. For this reason, indigenous communities and health agents fear the misuse of the kambô, or the inappropriate use of the species, which can result in health complications or even death of users. This article seeks to provide a transdisciplinary review that integrates knowledge regarding the biology of P. bicolor, ethnoknowledge about the ritual of the kambô, and the chemistry and pharmacology of the skin secretion of this species, in addition to medical aspects of the indiscriminate use of the kambô. Furthermore, this review seeks to shed light on perspectives on the future of research related to the kambô.

KAMBO: NATURAL DRUG OR POTENTIAL TOXIC AGENT? A LITERATURE REVIEW OF ACUTE POISONING CASES

Kambo is the name of a natural substance derived from the glandular secretions of the amphibian Phyllomedusa bicolor, a species native to regions in South America. The communities living in these areas administer the substance generally transdermally during rituals for religious-purifying purposes, producing small skin burns. The scientific literature has reported some cases of intoxication following the use of Kambo but this aspect is still poorly understood. In fact, no shared therapy protocols exist for these events nor any real legislation on Kambo. The purpose of this work was to examine all cases of acute intoxication resulting from the administration of Kambo and published over the last 10 years, illustrating clinical signs, laboratory findings, instrumental tests, and therapy. The several cases identified in our review confirm that acute Kambo intoxication can occur, with serious and life-threatening effects. We developed a protocol aimed at the early diagnosis of cases of suspected acute intoxication by creating a treatment algorithm. The study aims to investigate the pathophysiology of these events in humans, proposing a protocol for the diagnosis and treatment of these cases that can be used by healthcare professionals.

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The use of Kambo has spread for distribution worldwide through numerous websites.

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The literature review confirmed that acute Kambo intoxication include possible side effects.

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Intoxication may affect various systems with laboratory or instrumental alterations.

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Intoxication may be reversible if promptly diagnosed and treated.

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An algorithm with adequate triage can support diagnosis and treatment.

Report of envenomation in humans by handling a dyeing poison frog Dendrobates tinctorius (SCHNEIDER, 1799) (Anura: Dendrobatidae) in the Amazon, Brazil

We report a case of envenomation by Dendrobates tinctorius in the northwest of the Amazon Forest. The patients were two men, who presented with numbness in the right arm and slight numbness in the lower lip, respectively. Dendrobates tinctorius secretions contain pumiliotoxin, one of several toxins found in the dendrobatidis skin, which interferes with muscle contraction and causes locomotor difficulties. Although Dendrobatidae is a family of anurans known for their venom, few studies describe the symptoms of envenomation in humans.