Citation

Gupta K, Jha M, Jadon RS, Sood R. BMJ Case Rep. 2017; 2017: bcr2017220802, bcr-2017-220802.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bcr-2017-220802

PMID

28942403

PMCID

PMC5747665

Abstract

We report a case of a young man who allegedly consumed 100 mL of an indigenous pesticide which is used for the killing of rats in households in India. The constituents were azadirachtin oil (40%), tea oil (15%), pine oil (25%) and kerosene oil (20%). He presented to us with shortness of breath and altered sensorium and was found to have fMetHb (fraction of methaemoglobin) level of 80%, which has been postulated to have a fatal outcome. He responded to a low dose of methylene blue along with intravenous vitamin C and the level of fMetHb came down to 20% within 1 hour. His sensorium improved markedly with a decrease in fMetHb to non-toxic levels and he was discharged 5 days after admission. A literature review pertaining to these constituents individually or in combination causing methaemoglobinaemia is discussed in the context of this case.

Language: en

Keywords

Humans; Adult; Male; Emergency Treatment; Diagnosis, Differential; resuscitation; Suicide, Attempted; poisoning; Pesticides; Infusions, Intravenous; Methemoglobinemia; Kerosene; Methylene Blue; Plant Oils; Ascorbic Acid