Toxins #1 – The Manchineel Tree

This week we find ourselves in the Caribbean so it seems fitting to write a few informative blogs about medical emergencies, specifically potential poisons that are peculiar to this part of the world. 

Manchineel Tree Poisoning: The Death Apple 

Recorded on the internet is an account of what happened to two curious gentlemen while staying on a Caribbean island:  Strolling along a beautiful, deserted beach in the Caribbean, they found some fruit that looked like small green apples under a large tree overhanging the beach. After one of the gentlemen took a bite of an apple and found it to be quite sweet and tasty, his friend and he both then each ate one and found them very satisfying.  After 10 minutes or so, they noticed an unusual burning sensation in their mouths that evolved into swelling and tightness of the throat and difficulty swallowing.  Alcohol seemed  to make the symptoms worse.      

poisonous tree 

Manchineel Tree: 

One particular toxic plant worth mentioning is the manchineel tree, Hippomane mancinella, also known as the beach apple or death apple.  This tree grows on the shores of islands and coastlines of the Caribbean Sea.  A large deciduous tree that has a small green apple-like fruit, it is considered to be one of the most poisonous plants on earth.  Given this distinction, it is a tree worth being able to recognize when traveling in this part of the world.  Do not sit under it, even during a rain storm, as the droplets of water falling off it contain enough toxic latex to cause a severe contact dermatitis.  For the same reason do not touch the leaves, the bark, or burn the wood.  The apple-like fruit of the tree contains a potentially deadly poison.  The two adventurers mentioned in the preceding paragraph might well have expired from their experimental taste-test.

This  tree contains tigliane phorbol esters.  Skin contact can cause blistering, burns, erythema, swelling, and inflammation.  If ingested, it will cause burning and swelling of the oral mucosa, esophageal ulcerations, edema, and cervical lymphadenopathy, making it impossible to swallow, difficult to talk, and hard to breathe.


Treatment consists of cleansing the skin with soap and water to remove the plant latex, being careful to avoid further exposure and using  antihistamines to minimize the immune response and the edema.

There is more information about this and other ocean-related toxins in a recent Wilderness Medicine Newsletter, entitled Poisonous Pearls.

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16 Responses to “Toxins #1 – The Manchineel Tree”

  1. Jessica Says:

    Thank you for this post. I am writing a novel and this tree plays a part. Do you know when the apples are produced?

  2. Ricardo Says:

    We visited an island in the Caribbean on the 13/7/12 where we would normally go to this particularbeach and have a sea bath, usually our bath at the beach would be around 6:30 a:m to 7:00a:m. However this beach is lined with the Manchineel trees. we have been told that trees are poisonous, but as i said earlier we have utilized this beach since we have know ourselves. We would normally rest our car keys and other items which we cannot take into the water on the sea shore near to the Manchineel. This morning the sea was so beautiful, like our Almighty God himself was on the beach the view was heavenly. At the time there were not many persons on the beach, any how we took a very short bath, whilst in the water I felt like eyes started to burn me, I told the wife the sea water appears to be very salty today which was causing my eyes to burn. We then left the water, I took up my car keys from on the sea sand not far from the Manchineel tree. Then my eyes started to burn me I told the wife when I get back to the guest house I will take a bath with fresh water to get rid of the irritation. We took about 5minutes to get to the guest house. When I was finished taking a bath in the bathroom with fresh tap water I thought every thing would be alright, this is when Friday the 13th really started. My wife drove me to the hospital (ambulance style) accompanied by a friend to the hospital where I received immediate attention. I was given saline solution to rinse my eyes, then I was given Ice cold patch to cool my eyes this treatment went on for about 4 hours with no ease, I was then given tablets for blistering. My feeling were nausea, disorientation, temporary blindness and the feeling of death. However my relief came sometime at around 5:00 p:m after I had fallen asleep. They say that Manchineel trees were planted to minimize soil errosion. I believe that the indigenous persons planted these trees to ward off persons coming onto the island? These trees today should be uprooted and destroyed (Drastic move) or proper signage indicating cause and effect also research carried out on the Manchineel.

  3. Ali H Says:

    Since we’re sharing Manchineel horror stories… I just returned, and am still recovering, from my sailing trip to Saint Vincent and the Grenadines. The only hiccup on the trip was on our visit to see the sea turtles at Tobago Cays. I had a little restroom ‘emergency’, and darted out of the water to find a private place in the shrubbery on land. Along the path, I grabbed about 5 leaves to wipe with. Being only a few days in the Caribbean, I hadn’t yet heard of the Manchineel tree. As you can guess, the leaves were poisonous, and resulted in extremely painful burns, blistering, surrounding skin irritation, and immense embarrassment.

    Treatment is, as you have all discovered, tricky. Benadryl ointment and cortisone cream (both used mainly for itch relief from other poisonous plants, bites, and stings) made it burn worse. The only thing that seemed to help (that we had on hand), was Polysporin ointment once the blisters had popped and calamine lotion to dry them up. A bag of ice would have been a welcome treatment had we had any. I wish I had access to this thread earlier to learn about the limes and aloe.

    Note to anyone going to the Tobago Cays – this area is a natural park, so it’s probably the reason why this shrub seems so prolific here… it’s all along the pathways. Don’t go near any foliage on shore unless you know what it is.

    I suppose in a few months I’ll be able to laugh about this…

  4. Brad Says:

    I was in Barbados on April 8th. I was curious about this tree when I seen it. I was especially intrigued by the white sap inside the branches. I made the mistake of rubbing my eyes with some of the residue still on my fingers. I felt the most intense pain I have ever known in my life, my eyes were on fire. I went back to the cruise ship immediately to see the dr. They proceeded to rinse out my eyes with salene solution. This did not help at all. They seen swelling in my eyes so immediately hooked me up to an I.V. With antihistamine. Then they inserted special lenses over my eyes and put an I.V. Of saline solution washing directly into each eye. This was the only relief I got, as soon as the I.V. Of salene solution would run dry, my eyes would be on fire again. I begged the Dr. To give me drops in my eyes to numb them. She tried 3 different types of drops for this and not one of them would help. Finally after about 5 hours of this I started to get relief. I ended up having to wear eye patches all night. Thankfully by the next morning my eyes were better and I was able to enjoy the rest of my vacation.

  5. Future Adventurer Says:

    This will probably prove to be most useful in the future when my adventure buddy and i do some traveling around there and he wants to try the “exotic apple” or use them as shelter from rain. Or if we want to try to poison our arrows or blow darts just for the heck of it.

  6. Maxine Says:

    i live on the island of st. kitts in the west indies and our friend a local man who owns horses thought his horses had been posioned due to the red blisters and swollen mouths of the horses almost like chemical burns but the vet has just informed us that it is the machineel tree possible they ate the new sprouting tree leaves or bush that grows by the sea where he had them tied up… poor horses they cannot eat or drink and are in such excrutiating pain it is hard to see and witness.. thank god the vets helped us with iv solutions for the horses and especially the baby colt.. he is almost a gonner… we have been hours helping these suffering animals and i pray they survive this horrible ordeal…

    • Kims Says:

      Stupid horses, usually animals do not need learning especially with eating, swimming, copulating etc… But you know what, Man is making the Earth Hell and Prison to other creatures

  7. Carrol Says:

    A few days ago my daughter, who is visiting with me in Anguilla, cleared a path from my back yard to the water. She nor I realized the machineel was one of the shrubs blocking the path. Within 5 hours she was beginning to break out in painful blisters and the next day they were spreading. She thought she had gotten into an island version of “poison ivy”. A trip to the pharmacy told her to treat with benadryl liquid and hydrocortizone ointment. After 4 days she is some better, but not yet healed. I had never noticed the plant before, but I will certainly tell everyone to avoid it from now on!

  8. Sharon Cobb Says:

    I visited St Croix where I had lived for 14 years and knew well the affects of the Manchineel Tree, but on this visit I unknowingly must have been near one because when I got home my neck and face began to burn and itch. It took two days for my face to swell and the itch to travel to my hands, arms and abdomen. I has now been seven days and it has continued to spread and worsen. I am taking Zyrtec and using benedral cream to no avail.

    • Tiffanie Says:

      Sharon, please let me know if you figure out how to get rid of it! Mine has been slowly getting worse for the past 7 days. It is itching like crazy and spreading up and down my arm. I haven’t found any remedies on the internet and will probably give in and go to the doctor soon.

      • Sharon Cobb Says:

        Mine is 11 days old and is still spreading. I take Zyrtec to no avail and shower in hot, hot water with temporary relief and swab the areas with 1/4 cup salt, 1/4 cup baking soda and 1 cup of boiling water. That helps most and for the longest time. It’s a mess though especially when it dries and flakes off. Good luck. I have it on my face, neck, arms, hands, belly and back. And I may just go mad. I’m not much help. I think it just takes time.

  9. Jeremy Says:

    Hi. My girlfriend and I took a bit out of the “apple” looking fruit and immediately spit it back out. We may have ingested a little of its juice. Anyone have an idea of how much you need to ingest to feel the residual affects? Suggestions? It has been an 1:30hr thus far. Feeling the peppery feeling in our mouths. Thank you.

  10. Li Says:

    I cut trails for researchers on San Salvador Island in the Bahamas. I unwittingly cut through some manchineel in Nov of 2012. I got it on my arms. It took several days for the mild burning to become what looked like acid burns. Although it is common on our island, the only clinic treated me for poisonwood, a plant related to poison ivy. It kept spreading and lasted for months, burning, scabbing, spreading. It finally seemed to be going away until I very lightly brushed into some again while setting traps for stray dogs and cats for a neutering/spay program. That was four months ago. It seems that it intensifies with each contact and it turned on other allergies I never had before. Since the second encounter, it goes away for a short time, then the poison seems to leach out of my skin in areas I didn’t realize I had contact, including neck and eye lids. It it a nightmare. I was given antihistamines and a topical cream (months ago) but the poison still seems to be in my system. Why is there so little information on treatments for this seemingly common tropical toxic tree? If anyone can provide answers, I would be very greatful. Good luck to those of you suffering this bloody plant. Be aware that you must wash everything that touches you, sheets, towels, etc. Do not let loved ones come in contact with any material you have touched. The poison oil gets on everything. I’m an artist and it is burning my eyes and it can cause blindness. I need help!

  11. Coral Cadman Says:

    Unwittingly, I ate 2 of the little so-called “apples of death” on our local beach 5 days ago, and ended up in the ER in San Pancho, Nayarit, here in Mexico. The clinic in the town of Sayulita was not informed as to protocols for treating damages from this strong poison.They offered me a cortisone shot which I refused, and high-tailed it to the hospital in San Pancho instead, and am glad I did. They made me chew a gross tasting white tablet, ordinarily given to people with bleeding ulcers, to coat the burned tissues of my mouth and throat, and put me on an IV of anti-histamine and gave me a strong laxative to move the poison out of my system rapidly. They would not permit me to drink water for a few hours, in hopes the chalky pills would coat the stomach too.

    There are no warning signs on the beaches, beneath this common tropical tree, so I have taken it upon myself when I am well enough, to make some wooden signs in Spanish and English, as people who are not from this region are clueless as to how dangerously toxic every part of the tree is. I still feel weak and queasy and am very glad to be alive, as I got to the hospital in time to arrest more radical destruction. The effects are lingering and I feel like crap. NO ONE seems to know what to do other than have me rest. I was actually dizzy, and saw strange green halos around the heads of the nurses, docs and my friends. It was a nightmare experience I hope to NEVER repeat. I’ve lived here for 9 years and no one ever told me “By the way, these tress are poisonous”, it looks like I’m going to be the one to take on the task of asking the town’s people to help me post warning signs on these deadly trees. The Galapagos Sea turtles apparently eat the fruits, to no ill effect, but they’re older than God, so I guess nothing kills them. :-)

  12. calyindyol Says:

    Like all medicines, Caverta (Sildenafil citrate) can cause some side effects. These effects are usually mild to moderate and usually don’t last longer than a few hours. Some of these side effects are more likely to occur with higher doses.
    The most common side effects of this medication are headache, flushing of the face and upset stomach.
    Less common side effects that may occur are temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes being more sensitive to light or blurred vision.

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