A fatal case of acetamiprid poisoning with turquoise urine |
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| Affiliation: | 1. FCFPSL–Professor in Forensic Medicine, Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka;2. Consultant Judicial Medical Officer, Teaching Hospital, Kandy, Kandy, Sri Lanka;1. Department of General Physiology, Medical Institute of Russian University of People Friendship, Research Institute of Human Morphology, Moscow, Russia;2. Department of Forensic Medicine and Toxicology, Government Medical College and Hospital, Chandigarh, 160030, India;3. Department of General Pathology and Pathological Physiology, Medical Institute of Russian University of People Friendship, Moscow, Russia;4. Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;5. Institute of General Resuscitation Named After V. A. Negovsky Federal State Budgetary Scientific Institution, Federal Scientific and Clinical Center of Reаnimatology and Rehabilitation, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;1. Department of Forensic Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka;2. Office of the Judicial Medical Officer, Colombo North Teaching Hospital, Ragama, Sri Lanka;1. Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, 200063, PR China;2. Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 211166, PR China;3. Yangpu Branch of Shanghai Public Security Bureau, Shanghai, 200090, PR China;4. Institute of Criminal Science and Technology, Putuo Branch of Shanghai Public Security Bureau, Shanghai, 200333, PR China;5. Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu, 211166, PR China;1. Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, PR China;2. Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, 400016, PR China;3. Chongqing Key Laboratory of Forensic Medicine, Chongqing, 400016, PR China;4. Technical Department of Interpol Corps of the Chongqing Public Bureau, Chongqing, China |
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| Abstract: | Acetamiprid is a member of neonicotinoid insecticides with a low risk of toxicity in humans. However, ingestion of large amounts may cause severe poisoning. This is the first case reported in the literature in which severe toxicity and death occurred after acetamiprid ingestion. A 57-year-old male patient consumed 50g/250mL of an insecticide formulation containing acetamiprid for suicidal purposes. The ambulance team performed cardiopulmonary resuscitation on the patient who had a cardiac arrest. His heart beat returned after a 15-min cardiopulmonary resuscitation, and afterward, he had tachycardia, hypotension, respiratory failure, high gap metabolic acidosis with a high lactate, hypokalemia, hypocalcemia, mydriasis, and coma. The patient underwent supportive treatment for a variety of symptoms. However, he died despite all supportive treatment. This case demonstrates that ingestion of large amounts of the acetamiprid and late presentation can be fatal despite all supportive care. |
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| Keywords: | Acetamiprid Fatal poisoning Metabolic acidosis Neonicotinoid Turquoise urine |
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