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Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report
BACKGROUND: The widespread use of pesticides in public health protection and agricultural pest control has caused severe environmental pollution and health hazards, especially in developing countries, including cases of severe acute and chronic human poisoning. Diabetic ketoacidosis is an uncommon m...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122673/ https://www.ncbi.nlm.nih.gov/pubmed/25078103 http://dx.doi.org/10.1186/1756-0500-7-485 |
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author | Badrane, Narjis Askour, Majda Berechid, Kamal Abidi, Khalid Dendane, Tarek Zeggwagh, Amine Ali |
author_facet | Badrane, Narjis Askour, Majda Berechid, Kamal Abidi, Khalid Dendane, Tarek Zeggwagh, Amine Ali |
author_sort | Badrane, Narjis |
collection | PubMed |
description | BACKGROUND: The widespread use of pesticides in public health protection and agricultural pest control has caused severe environmental pollution and health hazards, especially in developing countries, including cases of severe acute and chronic human poisoning. Diabetic ketoacidosis is an uncommon manifestation of acute pesticide poisoning. Suicidal pesticide poisoning by injection is also an unusual way to take poison. We report a severe pesticide mixture poisoning case with diabetic ketoacidosis in an adult with improved outcome after supportive treatment and large doses of atropine. CASE PRESENTATION: A 30-year-old unmarried Moroccan Arab male with a previous history of active polysubstance abuse and behavior disorders had ingested and self injected intravenously into his forearm an unknown amount of a mixture of chlorpyrifos and cypermethrin. He developed muscarinic and nicotinic symptoms with hypothermia, inflammation in the site of the pesticide injection without necrosis. Red blood cell cholinesterase and plasma cholinesterase were very low (<10%). By day 3, the patient developed stroke with hypotension (80/50 mmHg) and tachycardia (143 pulses /min). Laboratory tests showed severe hyperglycemia (4.49 g/dL), hypokaliemia (2.4 mEq/L), glycosuria, ketonuria and low bicarbonate levels (12 mEq/L) with improvement after intensive medical treatment and treatment by atropine. CONCLUSION: Suicidal poisonings with self-injection of insecticide were rarely reported but could be associated with severe local and systemic complications. The oxidative stress caused by pyrethroids and organophosphates poisoning could explain the occurrence of hyperglycemia and ketoacidosis. |
format | Online Article Text |
id | pubmed-4122673 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41226732014-08-07 Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report Badrane, Narjis Askour, Majda Berechid, Kamal Abidi, Khalid Dendane, Tarek Zeggwagh, Amine Ali BMC Res Notes Case Report BACKGROUND: The widespread use of pesticides in public health protection and agricultural pest control has caused severe environmental pollution and health hazards, especially in developing countries, including cases of severe acute and chronic human poisoning. Diabetic ketoacidosis is an uncommon manifestation of acute pesticide poisoning. Suicidal pesticide poisoning by injection is also an unusual way to take poison. We report a severe pesticide mixture poisoning case with diabetic ketoacidosis in an adult with improved outcome after supportive treatment and large doses of atropine. CASE PRESENTATION: A 30-year-old unmarried Moroccan Arab male with a previous history of active polysubstance abuse and behavior disorders had ingested and self injected intravenously into his forearm an unknown amount of a mixture of chlorpyrifos and cypermethrin. He developed muscarinic and nicotinic symptoms with hypothermia, inflammation in the site of the pesticide injection without necrosis. Red blood cell cholinesterase and plasma cholinesterase were very low (<10%). By day 3, the patient developed stroke with hypotension (80/50 mmHg) and tachycardia (143 pulses /min). Laboratory tests showed severe hyperglycemia (4.49 g/dL), hypokaliemia (2.4 mEq/L), glycosuria, ketonuria and low bicarbonate levels (12 mEq/L) with improvement after intensive medical treatment and treatment by atropine. CONCLUSION: Suicidal poisonings with self-injection of insecticide were rarely reported but could be associated with severe local and systemic complications. The oxidative stress caused by pyrethroids and organophosphates poisoning could explain the occurrence of hyperglycemia and ketoacidosis. BioMed Central 2014-07-31 /pmc/articles/PMC4122673/ /pubmed/25078103 http://dx.doi.org/10.1186/1756-0500-7-485 Text en Copyright © 2014 Badrane et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Badrane, Narjis Askour, Majda Berechid, Kamal Abidi, Khalid Dendane, Tarek Zeggwagh, Amine Ali Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
title | Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
title_full | Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
title_fullStr | Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
title_full_unstemmed | Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
title_short | Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
title_sort | severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122673/ https://www.ncbi.nlm.nih.gov/pubmed/25078103 http://dx.doi.org/10.1186/1756-0500-7-485 |
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