Introduction. Glutaraldehyde and quaternary ammonium compounds are widely used as disinfectants and sterilizing agents. Glutaraldehyde is irritating to the eyes and upper respiratory tract, and has been associated with occupational asthma. Acute oral ingestion of a concentrated solution has not been previously reported in humans. Case Report. A 19-year-old woman presented after deliberate ingestion of a biocide containing glutaraldehyde and a quaternary ammonium compound. She developed respiratory distress and severe metabolic acidosis 10 hours after admission. Marked laryngeal edema was noted when she was being intubated. She eventually improved following supportive care and was discharged alive after 9 hospital days. Discussion. There are no reports of acute ingestions of both glutaraldehyde and quaternary ammonium compounds. As both these substances are known to cause metabolic acidosis, localized edema, erosion and sensitization of both the respiratory and alimentary tract. The clinical effect may be additive or synergistic. Conclusions. Omnicide ingestion should be closely monitored for metabolic acidosis and laryngeal edema which may progress to upper airway obstruction requiring urgent airway stabilization.

Flower-N is a flowering stimulant composition with 22% nitrobenzene. The main systemic effect associated with human exposure to nitrobenzene is methaemoglobinaemia. A 25-year-old female presented after 3 hours following ingestion of 100 ml of 22% Nitrobenzene (Flower-N). Her initial methaemoglobin (MetHb) was 81%; this responded to methylene blue. However, she developed recurrent methaemoglobinaemia on days 3 and 5 with haemolytic anaemia. The treatments that were provided were repeated methylene blue treatment and exchange transfusion. Nitrobenzene ingestion is a known cause of methaemoglobinaemia and haemolytic anaemia. The recurrence suggests a long half-life. The recurrent MetHb has clinical implications as patients may require repeated treatment. Massive nitrobenzene ingestion can cause haemolysis and recurrent methaemoglobinaemia.