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An 80-Year-Old Woman with Alzheimer Disease and Accidental Poisoning with Pyrethroid Pesticide Successfully Treated with Intravenous Lipid Emulsion

Julio C. Diez-Sepulveda, Francisco L. Uribe-Buritica, Ana Maria Angel-Isaza, Luis Alfonso Bustamante-Cristancho, Felipe Mejia-Herrera, Fredy A. Watts-Pajaro, Maurix Fernando Rojas-Martinez

(Emergency Department, Fundación Valle del Lili, Cali, Colombia)

Am J Case Rep 2021; 22:e928420

DOI: 10.12659/AJCR.928420

BACKGROUND: Pesticides are commonly used in the agricultural industry. Overdose can be lethal due to its effects generating closure of the voltage-gated sodium channels in the axonal membranes. Most case reports of toxicity refer to skin exposure and there are very few that refer to effects due to its oral intake.
CASE REPORT: We report the case of an elderly woman with Alzheimer disease who accidentally swallowed 50 g of Lambda Cyhalothrin (GOLPE 5 M E®), a pyrethroid of medium toxicity containing a cyano group. It severely harmed the woman’s health, causing severe central nervous system depression and refractory vasodilated shock requiring the use of vasopressors. Its management was challenging, requiring orotracheal intubation, vasopressors, and admission to the Intensive Care Unit (ICU). The emergency care team decided to use intravenous lipid emulsion, which clearly helped with the recovery and successful discharge of the patient.
CONCLUSIONS: The use of intravenous lipid emulsion for the treatment of pyrethroid poisoning can lead to successful outcomes, as described in this case report.

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