van den Bersselaar L R, van der Hoeven J G, de Jong B
Department of Intensive Care Medicine, Radboudumc, Nijmegen, The Netherlands.
Department of Intensive Care Medicine, Gelre Ziekenhuizen, Apeldoorn, The Netherlands.
BMJ Case Rep. 2019 Apr 16;12(4):e227936. doi: 10.1136/bcr-2018-227936.
Pesticide self-poisoning is rare in developed countries. We report a suicide case after inhalation of a pyrethrins containing insecticide spray. The patient presented at the emergency department with respiratory failure. Despite mechanical ventilation, he developed severe pulmonary inflammation with a systemic inflammatory response syndrome and died 5 days later. Studies reporting on acute pyrethrins or pyrethroids insecticide poisoning in both occupational and non-occupational cases usually describe mild and self-limiting respiratory symptoms as the predominant symptom. Severe or fatal cases of pyrethrins or pyrethroids poisoning are very rare. Patients with asthma or allergies are apparently more at risk for severe symptoms. In these cases, early and aggressive treatment with bronchodilatators, steroids, antihistamines and epinephrine should be considered.
农药自我中毒在发达国家较为罕见。我们报告一例吸入含除虫菊酯杀虫剂喷雾后自杀的病例。患者因呼吸衰竭就诊于急诊科。尽管接受了机械通气，他仍出现了严重的肺部炎症并伴有全身炎症反应综合征，5天后死亡。关于急性除虫菊酯或拟除虫菊酯类杀虫剂中毒的职业性和非职业性病例的研究通常将轻度且自限性的呼吸道症状描述为主要症状。除虫菊酯或拟除虫菊酯中毒的严重或致命病例非常罕见。哮喘或过敏患者显然更易出现严重症状。对于这些病例，应考虑早期积极使用支气管扩张剂、类固醇、抗组胺药和肾上腺素进行治疗。
