Fatal bromethalin poisoning.
Bromethalin is a neurotoxin found in some rodenticides. A delusional 21-year-old male presented to a hospital with altered mental status the day after ingesting a bromethalin-based rodenticide. He died 7 days after his self-reported exposure to c. 17 mg bromethalin (equivalent to 0.33 mg bromethalin/kg). His clinicopathologic course was characterized by altered mental status, obtundation, increased cerebrospinal fluid pressure, cerebral edema, death, and diffuse histologic vacuolization of the white matter in the central nervous system seen on microscopic examination at autopsy. The presence of a demethylated form of bromethalin in the patient's liver and brain was confirmed by gas chromatography with mass spectrometry. Clinical signs and lesions observed in this patient are similar to those seen in animals poisoned with bromethalin. This case illustrates the potential for bromethalin ingestion to result in fatal human poisoning.
Pasquale-Styles
Melissa A
MA
Office of the Chief Medical Examiner, 520 First Avenue, New York, NY 10016, USA. pasqualemd@hotmail.com
Sochaski
Mark A
MA
Dorman
David C
DC
Krell
Willane S
WS
Shah
Aashit K
AK
Schmidt
Carl J
CJ
D000328:Adult; D000814:Aniline Compounds / Q000032:analysis / Q000506:poisoning*; D001923:Brain Chemistry; D006801:Humans; D008099:Liver / Q000737:chemistry; D008297:Male; D009498:Neurotoxins / Q000032:analysis / Q000506:poisoning*; D012378:Rodenticides / Q000737:chemistry; D014617:Vacuoles
D000814:Aniline Compounds; D009498:Neurotoxins; D012378:Rodenticides; C040307:bromethalin