Cardiac and respiratory arrest in a 12‐year‐old girl with acute permethrin oral toxicity: A case report

Abstract

is the most frequently used type I synthetic pyrethroid insecticide, which is extensively used worldwide. 1 However, the expanded use of permethrin might cause various toxic effects on humans, including neurotoxicity, immunotoxicity, cardiotoxicity, hepatotoxicity, digestive system toxicity, and cytotoxicity, and also reproductive, genotoxic, and hematotoxic effects. 2 According to the European Chemicals Agency (ECHA), permethrin may be fatal if swallowed and enters airways (Aspiration hazard, Category 1 H304). 3 The main molecular targets of synthetic pyrethroids are voltage-dependent sodium channels (VDSC); they bind to these channels and delay the inactivation of sodium channels, resulting in neurotoxic effects and, ultimately, death. 4 The main type of exposure is dermal absorption, while its major neurotoxic mechanisms include oxidative stress, inflammation, neuronal cell loss, and mitochondrial dysfunction. 5 Permethrin is administered as the first-line therapy for scabies in pediatric patients older than 2 months in many countries, which may lead to accidental poisoning in few cases, especially among children. 6 Despite its global application, there have been scarce reports of pediatric toxicity following permethrin administration. The present report describes the case of a 12-year-old girl with cardiac and respiratory arrest resulting from self-induced oral toxicity by permethrin. | CASE PRESENTATIONA 12-year-old Afghan girl, with no previous medical problem, drank an unknown insecticide covertly at home. Two hours after ingestion, symptoms of headache, vertigo, vomiting, dyspnea, and confusion presented at home, and after