Delayed hyperthermia from chlorfenapyr overdose

Chomin, James; Heuser, William; Nogar, Joshua; Ramnarine, Mityanand; Stripp, Richard; Sud, Payal

doi:10.1016/j.ajem.2018.05.035

Cited by 18 publications

(18 citation statements)

References 6 publications

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“… 5 , 10 Rhabdomyolysis, metabolic acidosis, and pancreatitis were also reported. 4 , 5 , 12 In most cases, organ function changes were similar to those reported herein. In the acute phase (<6 days), liver impairment and elevated CK levels were the first signs and symptoms; these ranged from minor to severe.…”

Section: Discussionsupporting

confidence: 84%

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A fatal case of chlorfenapyr poisoning and a review of the literature

Chien

2022

J Int Med Res

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Background Chlorfenapyr is a widely used pesticide and is classified as moderately hazardous to human health. Ingestion usually leads to mortality in humans. However, chlorfenapyr toxicity has a variable course and mechanism of action. Case presentation: We report the case of a 79-year-old female who ingested chlorfenapyr with the intent to commit suicide. The liquid was ingested 2 hours before she was brought to our emergency department. Gastric lavage was immediately performed. On admission, laboratory examinations revealed mildly elevated liver enzyme and creatinine kinase levels. Acute fever occurred on day 7; on day 8, the patient died of progressive respiratory distress and conscious disturbance. Chlorfenapyr toxicity leads to high rates of mortality (75%) and causes damage to the liver and the nervous system. Conclusions It is necessary to observe patients with chlorfenapyr toxicity for 3 weeks because no significant abnormalities occur in the early phase. The onset of fever and deterioration of consciousness is a warning sign of a sudden fatal outcome. We review the literature and discuss neurologic and cardiopulmonary impairment in the clinical course of chlorfenapyr poisoning.

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Section: Discussionsupporting

confidence: 84%

“…In the subacute phase, neurotoxicity (including hyperthermia, cardiopulmonary instability, and mortality) was revealed. 4 , 5 , 9 , 10 , 12 …”

Section: Discussionmentioning

confidence: 99%

A fatal case of chlorfenapyr poisoning and a review of the literature

Chien

2022

J Int Med Res

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“…We searched articles using "chlorfenapyr" and "case" as keywords in titles and abstracts in PubMed, EMBASE, Google Scholar, and Scopus databases from 01/01/1970 to 03/01/2021 and found 12 case reports with full text (Table 2) (Ref. [3][4][5][6][7][8][9][10][11][12][13][14]…”

Section: Discussionmentioning

confidence: 99%

“…The patients who swallowed 300 mL [5] or 250 mL [6] of chlorfenapyr died despite hemodialysis (HD) probably owing to the excessive intake. A 71-year-old-male [13] swallowed 100 mL of chlorfenapyr and died because of the excessive intake.…”

Section: Discussionmentioning

confidence: 99%

Brain damage caused by chlorfenapyr poisoning: a case report and literature review

2021

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Introduction: Chlorfenapyr poisoning is uncommon, but fatal, and is often ignored. Chlorfenapyr inhibits ATP production in the mitochondrial of lipid-rich organs such as the brain. The initial symptoms of chlorfenapyr poisoning are not serious and are usually ignored; fever and unconsciousness are the main signs. Patients often die of brain damage, and survivors often present toxic leukoencephalopathy. Case report: We report a case of a 15-year-old female who swallowed 10 mL of 10%chlorfenapyr, and was subjected to gastric lavage one hour after ingestion. The patient felt no discomfort on the first and second day after lavage and went to school. On the third day, the patient complained of a headache and rested at home. On the fourth day, the patient still complained of headache, and the condition progressed to confusion and fever; therefore, the patient was admitted to the emergency room and underwent hemoperfusion. Cerebral CT revealed diffuse brain edema. The patient died on the fourth day because of central fever, brain hernia, and brain dysfunction. Conclusion: Chlorfenapyr poisoning is fatal, even in small doses. Patients suspected of chlorfenapyr poisoning should be closely observed and promptly treated by hemoperfusion.

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“…Chlorfenapyr poisoning exhibits high mortality. Fatal cases are reported in China [ 3 , 4 ], India [ 5 ], Japan [ 6 , 7 ], Korea [ 2 , 8 ], and North America [ 9 ]. Of 15 case reports available so far, only 3 cases reported survival after intentional ingestion.…”

Section: Introductionmentioning

confidence: 99%