Accidental Cypermethrin Inhalation Poisoning Mistaken for Organophosphate Poisoning- A Private Rural Hospital Experience
DOI:
https://doi.org/10.64321/jcr.v3i1.06Keywords:
Pyrethroid, organophosphate-like toxidrome, Cypermethrin, Dermal cleansing, Atropine sulphateAbstract
Nigeria is a major pesticide importer in West Africa, owing to its large agricultural practices. Pesticides are necessary for food security and economic survival, especially in a developing economy like Nigeria. A class II pyrethroid, cypermethrin is frequently and extensively used as an insecticide in Nigeria and Africa. Exposure through ingestion of contaminated food, skin contact, or inhalation can result in poisoning. The majority of its harmful consequences show up as gastrointestinal and neurological problems. Although they are uncommon, severe cases of pyrethroid poisonings can manifest as an organophosphate-like toxidrome. This presents a diagnostic dilemma.
This case concerns a 16-year-old male from a rural Community in Ovia-North East Local government, of Edo State, Nigeria, who was diagnosed with accidental cypermethrin inhalation/ poisoning when he soaked his hair with cypermethrin-containing insecticide spray in an attempt to take care of the lice on his hair. He was initially diagnosed with a suspected case of organophosphate poisoning with hallucinations and chemical pneumonitis. He made a full recovery 2 days later after mechanical ventilation, Intravenous Fluid administration and symptomatic treatment with a low-dose muscarinic antagonist, atropine sulphate.
Cypermethrin and other pyrethroid-containing insect sprays are so easily obtained over the counter, therefore, frontline and critical care staff are facing a growing diagnostic challenge. Raising awareness of the organophosphate-like toxidrome upon presentation is the goal of this case report. One of the most important aspects of cypermethrin treatment is thorough leaning of the skin. Atropine at low doses may be used if necessary.
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