Rapid Death from Aluminum Phosphide Poisoning

Abstract

Abstract Aluminum phosphite is a chemical used as an insecticide and pesticide to improve the storage conditions of agricultural products. Combined with the humidity in the air or after being taken orally as a tablet, it reacts with the acidic environment of the stomach and turns into phosphine gas and can cause poisoning. Suicidal use is also common. When poisoning develops, deep metabolic acidosis, hypotensive shock, acute respiratory failure, multi-organ failure, cardiac arrest and death may occur. Resistant hypotension and deep metabolic acidosis are the most important indicators of poor prognosis. In this case, an 18 year old male patient was brought to the emergency room after taking 3 tablets of aluminum phosphide. The patient was unconscious and had hypotensive shock. Despite gastric lavage, massive fluid replacement, positive inotropes, sodium bicarbonate, intravenous N acetyl cysteine loading, and hemodialysis, the patient died 6 hours after admission to the emergency department.