Fatal cyanide poisoning from cassava-based meal.

Three patients admitted to the Accident and Emergency Unit of Lagos University Teaching Hospital (LUTH) after eating a cassava based meal 'Gari' died shortly after admission. The patients vomited and complained of abdominal pain immediately after the meal. They were unconscious with renal failure and died of cardiopulmonary arrest. The cyanide levels in the blood and urine averaged 1.12 and 0.54 mg l-1, respectively. Cassava contains cyanogenic glycosides which slowly release cyanide and this may have been responsible for the death of these patients. There is an urgent need to establish maximum tolerable levels of cyanide in 'Gari' and other cassava food products.