Acute poisoning with neonicotinoid insecticides: a case report and literature review.
Neonicotinoids are a new class of insecticides widely applied for crop protection. These insecticides act as agonists at nicotinic acetylcholine receptors, which cause insect paralysis and death. The high specificity for receptors in insects was considered to possess highly selective toxicity to insects and relative sparing of mammals. However, an increasing number of cases of acute neonicotinoid poisoning have been reported in recent years. We reported a man who developed respiratory failure and shock after ingestion of neonicotinoid insecticide. A detailed literature review found that respiratory, cardiovascular and certain neurological presentations are warning signs of severe neonicotinoid intoxication. The amounts of ingested neonicotinoid insecticide and the plasma neonicotinoid concentration are not useful guides for the management of intoxicated patients. Supportive treatment and decontamination are the practical methods for the management of all neonicotinoid-poisoned patients.
Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan.
Pei-Chen
PC
Lin
Hung-Jung
HJ
Lin
Yu-Ying
YY
Liao
How-Ran
HR
Guo
Kuo-Tai
KT
Chen
D000208:Acute Disease; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000506:poisoning*; D011978:Receptors, Nicotinic / Q000187:drug effects / Q000378:metabolism; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D012769:Shock / Q000139:chemically induced; D013406:Suicide, Attempted
D007306:Insecticides; D018722:Nicotinic Agonists; D011978:Receptors, Nicotinic