Dichlorvos poisoning after intramuscular injection

Clinical characteristics and treatment of mixed-pesticide poisoning in a patient: reflections on a particular case

Patients who commit suicide often deliberately hide their medical history. Given that taking pesticides is one of the most common methods of suicide, other forms of poisoning may be neglected in clinical practice. We report here a case of mixed-pesticide poisoning. The patient was poisoned by oral administration of a coumarin rodenticide in combination with an intramuscular injection of organophosphorus (OP) pesticide. The patient was treated with vitamin K1, cholinesterase reactivators, atropine, ventilator-assisted ventilation, and bedside debridement. Her condition gradually stabilized and she eventually recovered and was discharged. Assessment of the causes of delayed diagnosis and treatment suggests that we need to improve early detection and treatment of acute poisoning. It is especially important to ask about the patient’s medical history, conduct a careful physical examination, and track the clinical symptoms and differential diagnosis of common poisoning. In addition to the three common routes of poisoning—oral, inhalation, and cutaneous mucosal contact—intramuscular injection of OP can also lead to severe poisoning, which manifests as respiratory failure.

Dichlorvos toxicity: A public health perspective

Pesticides are used in agriculture and in domestic pest control. Dichlorvos, an organophosphate, is a predominant pesticide used in domestic insect control in developing countries. Acute and prolonged exposure may lead to death, genotoxic, neurological, reproductive, carcinogenic, immunological, hepatic, renal, respiratory, metabolic, dermal and other systemic effects. Its toxicity is due to the ability of the compound to inhibit acetyl cholinesterase at cholinergic junction of the nervous system. This study is a review of the toxicological effects of dichlorvos in a public health perspective.

Atypical manifestations of organophosphorus poisoning following subcutaneous injection of Dichlorvos with suicidal intention

Current case report describes a 37-year-old female patient who was admitted to the hospital following subcutaneous injection of Dichlorvos with an insulin syringe. The only peripheral cholinergic sign observed on admission was excessive salivation with bilateral pyramidal tract signs. Locally she had necrosis of skin and subcutaneous tissue with surrounding blisters. In the subsequent course of her illness, she developed respiratory arrest requiring ventilator support. She also had delayed extrapyramidal manifestations. Relevant literature is reviewed. Possibility of route-specific, delayed predominant central nervous system effect of Dichlorvos postulated.

Parasuicidal poisoning by intramuscular injection of insecticide: A case report

Suicidal poisoning by ingestion of organophosphate (OP) insecticides represents a serious emergency with a high mortality rate. However, attempted suicide via the parenteral route has rarely been reported. The present study reports a case of parasuicide by self-injection of an organophosphorus insecticide (phoxim, phenylglyoxylonitrile oxime O,O-diethyl phosphorothioate) into the distal region of the left arm. The patient developed necrosis at the injection site and an abscess of the affected limb following injection. A fasciotomy and surgical debridement resulted in the symptoms of the patient disappearing within a few days and were vital in shortening the course of the disease.

Dichlorvos-induced hepatotoxicity in rats and the protective effects of vitamins C and E

Dichlorvos is an organophosphate insecticide that is widely used in pest control. Vitamin C (200mg/kg)+vitamin E (200mg/kg), dichlorvos (1.6mg/kg), or a combination of vitamin C (200mg/kg)+vitamin E (200mg/kg)+dichlorvos (1.6mg/kg) was given to rats via oral gavage for 7 weeks. When rats of the dichlorvos-treated group and the vitamins+dichlorvos-treated group were compared with the control group, body weights were decreased and liver weights were increased significantly at the end of the 4th and 7th week. Serum total protein, albumin, triglyceride, low density lipoprotein-cholesterol (VLDL-cholesterol) levels were decreased, and serum alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl-transferase (GGT), lactate dehydrogenase (LDH), and total cholesterol levels were increased significantly at the end of the 4th and 7th week in the dichlorvos- and vitamins+dichlorvos-treated rats. There was a statistically significant difference for all biochemical parameters when the vitamins+dichlorvos-treated group was compared with the dichlorvos-treated group at the end of the 4th and 7th week. In an electron microscopic investigation, swelling of mitochondria and dilatation of endoplasmic reticulum were observed in liver cells of the dichlorvos- and vitamins+dichlorvos-treated rats at the end of the 4th and 7th week. As a result, vitamins C and E reduced dichlorvos hepatotoxicity, but vitamins C and E did not confer complete protection.