title: Rhabdomyolysis from an intramuscular injection of glyphosate-surfactant herbicide.
abstract: BACKGROUND
  Glyphosate-surfactant herbicide (GlySH) is widely used as a non-selective herbicide. Most intoxicated cases are from ingestion, inhalation, and skin exposure. Intramuscular injection of GlySH has never been reported. We present a case of GlySH intoxication via intramuscular injection.
  
  
  METHODS
  A 42-year-old woman came to the emergency department complaining of painful swelling of left upper limb for 12 h. She had performed an intramuscular injection of 6 mL of GlySH over the lateral aspect of the left elbow 15 h previously. Physical examination disclosed painful swelling over left distal arm, elbow, and forearm with three needle punctures. CT scan revealed ill-defined areas of heterogeneous high density with marked swelling at subcutaneous tissue over posterior aspect of the elbow.
  
  
  CONCLUSIONS
  The mechanism of toxicity of GlySH is complicated and surfactant was thought to play an important role in GlySH intoxication. Intramuscular GlySH poisoning is different from oral GlySH intoxication. Care should be taken when monitoring acute rhabdomyolysis and compartment syndrome, which may develop rapidly and contribute to the surfactant component of glyphosate formulation.
authors.affiliation: Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
authors.forename: Sheng-Fu
authors.initials: SF
authors.lastname: Weng
authors.forename: Dong-Zong
authors.initials: DZ
authors.lastname: Hung
authors.forename: Sung-Yuan
authors.initials: SY
authors.lastname: Hu
authors.forename: Yu-Tse
authors.initials: YT
authors.lastname: Tsan
authors.forename: Lee-Min
authors.initials: LM
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D005998:Glycine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000506:poisoning; D006540:Herbicides / Q000008:administration & dosage / Q000506:poisoning; D006801:Humans; D007273:Injections, Intramuscular; D012206:Rhabdomyolysis / Q000139:chemically induced*; D013406:Suicide, Attempted; D013501:Surface-Active Agents / Q000506:poisoning*; D000097797:Glyphosate
chemical_list: D005998:Glycine; D006540:Herbicides; D013501:Surface-Active Agents; D000097797:Glyphosate