Rhabdomyolysis from an intramuscular injection of glyphosate-surfactant herbicide.
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.
Weng
Sheng-Fu
SF
Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Hung
Dong-Zong
DZ
Hu
Sung-Yuan
SY
Tsan
Yu-Tse
YT
Wang
Lee-Min
LM
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
D005998:Glycine; D006540:Herbicides; D013501:Surface-Active Agents; D000097797:Glyphosate