• Christopher Raciti, Melba Blanzaco, and Jeffrey Bernstein.
• Department of Emergency Medicine, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA. Electronic address: christopher.raciti@msmc.com.
• Am J Emerg Med. 2023 Aug 1; 70: 208.e1208.e3208.e1-208.e3.

AbstractWe detail a case of a 74-year-old female with a history of chronic kidney disease (CKD) and diabetes mellitus (DM) who initially presented to the Emergency Department (ED) with intractable hiccups after ingesting two whole starfruit (SF) and quickly became critically ill while in the ED. Our patient was admitted and received several rounds of hemodialysis, but efforts proved futile, as the patient expired during her hospital course. To the best of our knowledge, this is the first fatality reported due to SF ingestion in the U.S, and highlights the need for both a better understanding of SF intoxication and clearer guidelines and timing for treatment. Due to the increased mortality of patients who consume SF with a medical history of CKD or DM, it is prudent that Emergency Physicians are familiar with the clinical presentation and management options for SF toxicity.Copyright © 2023 Elsevier Inc. All rights reserved.

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