
Toxicology Visual Pearls
About the Program
The Toxicology Visual Pearls series is a collaboration between ACMT and Academic Life in Emergency Medicine (ALiEM.) The pearls are open-access, expert peer-reviewed, toxicology-related visual stimuli followed by a question and discussion. The authors and editors volunteer their time and expertise to bring this well-regarded series to readers of the ALiEM blog. The series is led by Drs. Louise Kao and Howard Greller from ACMT and Dr. Kaitlin Bowers from ALiEM.
About ALiEM: ALiEM aims to enhance how medical providers and trainees can gain public access to high-quality, educational content while also engaging in a dialogue about best-practices in EM and medical education. ALiEM strives to reshape medical education and academia in their evolution beyond the traditional classroom.
How to Submit a Pearl
If you are interested in submitting a pearl for the series please see the submission guidelines below.
Please read the New Author Guidelines to prepare your pearl submission.
Below are links to all toxicology visual pearls. Click the button to view the photos, prompt, answers, and access the full post (some include other media including charts and videos.)

Feb 7, 2024
Hiss-teria Averted
By: Sean Flannigan, MD and Erik Fisher, MD

Aug 2, 2024
A “Purplexing” Finding
By: Kellie LeVine McKenzie, MD and Matthew Robert Dernbach, MD

July 26, 2024
Household Plant Gone Wrong
By: Deryan Smith, MD and Kathryn T. Kopec, DO

July 17, 2024
Skin Lesions
By: Mark Baumgarten, MD and Ann-Jeannette Geib, MD

July 10, 2024
Along Comes a Spider
By: Doug Maslowski MD and Anna Dulaney, PharmD, DABAT

May 29, 2024
Lye to the Eye
By: Hannah Corral, MD and Ann-Jeannette Geib, MD

May 22, 2024
Watt – Ever is that Foreign Body?
By: Carrie Bissell, MD and Kathryn T. Kopec, DO

April 24, 2024
Kitchen Cabinet High
By: Steven M. Perry, MD and Christine Murphy, MD
April 10, 2024
Abdominal Bruising
By: Maha M Farid MBBCh, MSc, PhD, Mohammed Abdelreheim, MSc, FRCPCH, CCT and Marwa Kh. Mohammed, MBBCh, MSc

March 27, 2024
A Bane to Existence
By: Nathaneal Franks, MD and Erik Fisher, MD

March 5, 2024
Bark with Some Bite
By: Ivan Ivanov, DO, Joanne Alonso, MD and Bhojnarine Seeram, MD

February 20, 2024
Salt, not Shock
By: Timothy Harmon, MD, Alexander Sidlak, MD and Meagan Singletary, PharmD
November 29, 2023
Needle to Necrosis
By: Christiana Agbonghae, MD and Ann-Jeannette Geib, MD

November 22, 2023
Poison Dart Frog
By: Nathaneal Franks, MD and Erik Fisher, MD

November 15, 2023
Apricot Kernels: Eat or Pass?
By: Laureen Nsofor, MD and Christine Murphy, MD
November 8, 2023
Making Rash Decisions
By: Destiny D. Folk, MD and Kathryn T. Kopec, DO

November 1, 2023
Who Doesn’t Like a Nice Rosé?
By: Allison Frazure, MD and Kathryn T. Kopec, DO

October 11, 2023
A Meal Worth Dying For
By: Faith Meyers, MD and Ann-Jeannette Geib, MD

October 4, 2023
On the Mark
By: Sofiya Diurba, MD and Ann-Jeannette Geib, MD

September 27, 2023
Mushroom Mishap
By: Kylee Brooks, MD and Anna Dulaney, PharmD, DABAT

August 16, 2023
Out of the Blue
By: Rafael Lima, MD and Arthur Daigh, MD

June 15, 2023
The Heart Won’t Go On and On
By: Sheila Goertemoeller, PharmD, DABAT, ICPS and Shan Yin, MD, MPH

June 7, 2023
Marcel the Shell with Toxins
By: Aaron Frolichstein, MD and Kathryn T. Kopec, DO
June 5, 2023
The Black Eschar
By: Alex Blackwell, MD and Kathryn T. Kopec, DO

February 24, 2023
Is the Silver Bullet for Refractory Vasoplegia Blue?
By: Parker Hambright, MD and Christine Murphy, MD
February 15, 2023
Swollen Lips
By: Maha M Farid MBBCh, MSc, PhD and Marwa Kh. Mohammed, MBBCh, MSc

June 6, 2022
Pretty (and Deadly) in Purple
By: Charles Harris III, MD and Ann-Jeannette Geib, MD

May 6, 2022
Substance-Induced Crystalluria: All That Glitters Is Not Gold
By: Alex Ponce, PharmD and Kris Nañagas, MD
April 4, 2022
Hypertension and Rash
By: Michael Semple, DO; Johana Lopez, MD; and Evan Schwarz, MD

May 26, 2021
Questions About Green Pee? Urine Luck!
By: Clare Gunn, MD and Kathryn T. Kopec, DO

April 7, 2021
In “Spore” Taste
By: Bryan Ross, MD and Kris Nañagas, MD

February 10, 2021
Necrotic Spider Bite
By: Michael Simpson, MD and Rebecca Bruccoleri, MD

January 20, 2021
A Poke in the Belly
By: Caitlin Baldwin, DO; Alexis Cates, DO; and Steven J. Walsh, MD

November 9, 2020
Case of a Toxic Tea
By: Nicholas Titelbaum, MD; Vir Singh, MD; and Daniel Nogee, MD

October 5, 2020
“I Have a Nagging Feeling About This”
By: Brian Lewis, MD; Gilbert Nelson, DO; Thomas Vu, DO; and Bryan Judge, MD, FACMT

September 14, 2020
Awake Seizures
By: Kregg Laundon, MD and Christine Murphy, MD
July 27, 2020
Perineal Skin Burns
By: Kregg Laundon, MD and Christine Murphy, MD

July 13, 2020
Caterpillar Envenomation
By: Nicholas Titelbaum, MD and Robert Avera, MD

June 22, 2020
I’ll Huff and I’ll Puff…
By: Kathryn T. Kopec, DO and Blake Bauer, MD

June 8, 2020
A Foraging Experience to Die For
By: Robert Goodnough, MD; Karla Canseco, MD; and Eddie Garcia, MD

May 11, 2020
The Doom from Down Under
By: Christopher Gardner, MD and Kathryn T. Kopec, DO

May 4, 2020
Tox Never Smelled So Good
By: Jessica Hoglund, MD and Kathryn T. Kopec, DO
February 17, 2020
Painful Foot
By: Ethen Ellington and Kathryn T. Kopec, DO

February 10, 2020
The Blood Sample Doesn’t Look Right
By: Austin Costa, MD and Kathryn T. Kopec, DO

January 20, 2020
Look, Don’t Touch
By: Ashley Mazo, MD and Christine Murphy, MD

January 1, 2020
Painful Hand
By: Angela Rombola, MD and Kathryn T. Kopec, DO

October 2, 2019
Getting Caught Yellow Handed
By: Francisco Javier Andrade Jr., MD and Kathryn T. Kopec, DO

August 16, 2019
Mushroom Mania
By: Mary Grady, MD and Christine Murphy, MD

June 26, 2019
Abnormal ECG
By: Colin O’Neill, MD and Kathryn T. Kopec, DO

May 27, 2019
Eating Foraged Wild Mushrooms
By: Alayna Prest, MD and Kris Nañagas, MD
February 18, 2019
Don’t Go Breaking My Heart
By: Jennifer Pallansch, MD; Margaret R. Lewis, MD; and Kathryn T. Kopec, DO

January 21, 2019
Abnormal Brain Imaging
By: Laura Tormoehlen, MD, FACMT, FAAN and Jeff C. Miller, MD

December 3, 2018
Blue Urine
By: Jennifer K. Potter, MD and Kathryn T. Kopec, DO

August 30, 2018
Toxic Mouth Pain
By: Heather A. Borek, MD and Matthew Eisenstat, MD

April 9, 2018
Spider Bite
By: Adrienne Hughes, MD and Robert G. Hendrickson, MD
February 21, 2018
Drug-Induced Rash
By: Jennifer S. Love, MD and Louise Kao, MD, FACMT

December 18, 2017
Toxic “Weed”
By: Leslie R. Dye, MD, FACMT
July 10, 2017
Discolored Skin/Urine
By: Hannah Malashock, MD
May 1, 2017
Exotic Viper Envenomation
By: Bryan Judge, MD, FACMT

April 3, 2017
Suicide Plant
By: Louise Kao, MD, FACMT

October 16, 2017
Drug-Induced QT Prolongation
By: Ryan Marino, MD and Anthony Pizon, MD, FACMT