Toxicological evaluation of a poisoning attributed to ingestion of malathion insect spray and correlation with in vitro inhibition of cholinesterases.

A 24-year-old Caucasian male was found dead from unknown causes at his farm home. At the scene, partially filled bottles of ORTHO Malathion 50 Insect Spray and CLOROX bleach were found. At the time of autopsy, a strong odour of a petroleum based product was prominent in the small intestine and in the liquid stool. A similar odour was also present in the liquids of both bottles. Generalized visceral and vascular congestion with oedema in various tissues was markedly present. Toxicological analysis of the gastric contents, intestinal contents, bile and liquid samples from the malathion and bleach bottles revealed the presence of malathion in the concentrations of 2.1 g/kg, 98 g/kg, 570 mg/l, 54% and 11%, respectively. In the blood and urine, malathion was not detected. Xylenes and other common volatile components of the spray were detected in the liquids from the bottles and in the gastric and intestinal contents. The ability of the blood and bile samples to inhibit, in vitro, rat serum cholinesterase and electric eel acetylcholinesterase was consistent with their malathion concentrations as the bile inhibited both enzymes, while the blood did not. These findings conclude that the death was associated with the ingestion of a commercial malathion insect spray.