A 34-year-old man was hospitalised with severe headaches and neck pain after consuming a Carolina Reaper chilli during a hot pepper-eating competition in the US. The incident, reported in BMJ Case Reports, marks the first known case of the chilli causing reversible cerebral vasoconstriction syndrome (RCVS).
The man began dry heaving immediately after eating the chilli, which rates up to 2.2 million on the Scoville scale—around 400 times hotter than a jalapeño. Over the following days, he experienced intense, brief neck pain and thunderclap headaches, prompting him to seek emergency care.
Doctors at Bassett Medical Center in New York conducted tests for neurological conditions, all of which returned negative. However, a CT scan revealed constriction in several brain arteries, leading to a diagnosis of RCVS. The condition, typically triggered by certain medications or drugs, resolved on its own within five weeks.
In 2016, a British man, Mark McNeil, was also hospitalised after eating chicken wings coated in Carolina Reaper sauce. He managed only three wings before suffering severe burning pain, but did not develop RCVS.
The Carolina Reaper, produced by the PuckerButt Pepper Company in South Carolina, holds the Guinness World Record for the hottest chilli, averaging 1.57 million Scoville heat units. Experts advise handling the pepper with gloves due to its extreme heat.
