title: Acute metaldehyde poisoning in Taiwan.
abstract: Metaldehyde, a cyclic tetramer of acetaldehyde, is a widely used molluscicide. Although cases with acute metaldehyde poisoning have been reported, the occurrence of severe poisoning is uncommon. To provide more information on human metaldehyde poisoning, we reviewed 15 cases of metaldehyde exposure reported to the Taiwan National Poison Control Center at the Taipei Veterans General Hospital between 1991 and 2002. While 7 patients were asymptomatic, the other 8 patients, including 4 who coingested alcohol or other poisons, exhibited toxic manifestations of abdominal pain, dizziness, nausea, irritation of oral mucosa, and seizures after oral exposure. One patient died after ingesting 12 g (or 258.6 mg/kg) of metaldehyde. Although the toxicity from metaldehyde is largely mild, the clinical course of metaldehyde poisoning may be rapidly deteriorating and fatal on rare occasions. Physicians should therefore be cautious in managing patients with metaldehyde poisoning, and vigorous supportive measures should be promptly instituted in patients who manifest severe toxicity.
authors.affiliation: Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road Section 2, Taipei 11217, Taiwan.
authors.forename: Chi-Chung
authors.initials: CC
authors.lastname: Shih
authors.forename: Shy-Shin
authors.initials: SS
authors.lastname: Chang
authors.forename: Yi-Ling
authors.initials: YL
authors.lastname: Chan
authors.forename: Jih-Chang
authors.initials: JC
authors.lastname: Chen
authors.forename: Meng-Wei
authors.initials: MW
authors.lastname: Chang
authors.forename: Meng-Sheng
authors.initials: MS
authors.lastname: Tung
authors.forename: Jou-Fang
authors.initials: JF
authors.lastname: Deng
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Yang
mesh_terms: D000079:Acetaldehyde / Q000031:analogs & derivatives* / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D008975:Molluscacides / Q000506:poisoning*; D011039:Poison Control Centers; D011041:Poisoning / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013406:Suicide, Attempted; D013624:Taiwan / Q000453:epidemiology
chemical_list: D008975:Molluscacides; C002935:metaldehyde; D000079:Acetaldehyde