Citation

van den Bersselaar LR, van der Hoeven JG, de Jong B. BMJ Case Rep. 2019; 12(4): e227936.

Affiliation

Department of Intensive Care Medicine, Gelre Ziekenhuizen, Apeldoorn, The Netherlands.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bcr-2018-227936

PMID

30996064

Abstract

Pesticide self-poisoning is rare in developed countries. We report a suicide case after inhalation of a pyrethrins containing insecticide spray. The patient presented at the emergency department with respiratory failure. Despite mechanical ventilation, he developed severe pulmonary inflammation with a systemic inflammatory response syndrome and died 5 days later. Studies reporting on acute pyrethrins or pyrethroids insecticide poisoning in both occupational and non-occupational cases usually describe mild and self-limiting respiratory symptoms as the predominant symptom. Severe or fatal cases of pyrethrins or pyrethroids poisoning are very rare. Patients with asthma or allergies are apparently more at risk for severe symptoms. In these cases, early and aggressive treatment with bronchodilatators, steroids, antihistamines and epinephrine should be considered.

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

adult intensive care; poisoning; respiratory medicine