A fatal case of acetamiprid poisoning with turquoise urine

Acetamiprid is a member of neonicotinoid insecticides with a low risk of toxicity in humans. However, ingestion of large amounts may cause severe poisoning. This is the first case reported in the literature in which severe toxicity and death occurred after acetamiprid ingestion. A 57-year-old male p...

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Bibliographic Details
Published in:Journal of forensic and legal medicine 2022-04, Vol.87, p.102335-102335, Article 102335
Main Authors: Gulen, Muge, Satar, Salim, Ince, Cagdas
Format: Article
Language:English
Subjects:
Acetamiprid
Fatal Outcome
Fatal poisoning
Heart Arrest
Humans
Insecticides
Male
Metabolic acidosis
Middle Aged
Neonicotinoid
Neonicotinoids
Poisoning - diagnosis
Respiratory Insufficiency
Turquoise urine
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Summary:Acetamiprid is a member of neonicotinoid insecticides with a low risk of toxicity in humans. However, ingestion of large amounts may cause severe poisoning. This is the first case reported in the literature in which severe toxicity and death occurred after acetamiprid ingestion. A 57-year-old male patient consumed 50g/250mL of an insecticide formulation containing acetamiprid for suicidal purposes. The ambulance team performed cardiopulmonary resuscitation on the patient who had a cardiac arrest. His heart beat returned after a 15-min cardiopulmonary resuscitation, and afterward, he had tachycardia, hypotension, respiratory failure, high gap metabolic acidosis with a high lactate, hypokalemia, hypocalcemia, mydriasis, and coma. The patient underwent supportive treatment for a variety of symptoms. However, he died despite all supportive treatment. This case demonstrates that ingestion of large amounts of the acetamiprid and late presentation can be fatal despite all supportive care. •The first case of acetamiprid related death reported in the literature.•Acetamiprid have low toxicity in humans but ingestion of large amounts of these insecticides causes severe poisoning.•The case presented myocardial depression, respiratory failure, metabolic acidosis and coma 12 hours after ingestion of acetamiprid.•Treatment of acute acetamiprid poisoning consists of symptomatic and supportive therapy.
ISSN:1752-928X
1878-7487
DOI:10.1016/j.jflm.2022.102335