Citation

Bigner JA, Fiester SE, Fulcher JW, Schammel CMG, Ward ME, Burney HE, Wheeler JF, Wheeler SK, Teuber JM. Am. J. Forensic Med. Pathol. 2021; 42(3): 282-285.

Copyright

(Copyright © 2021, Lippincott Williams and Wilkins)

DOI

10.1097/PAF.0000000000000660

PMID

33491949

Abstract

Glyphosate is an organophosphorus compound and the active ingredient in commonly used herbicides, whereas polyoxyethyleneamine (POEA) is a nonionic surfactant often coupled with glyphosate in these herbicides to increase their efficacy. Cases of glyphosate-POEA ingestion have shown a variety of outcomes, ranging from skin and mucosal surface irritation to death. Here, we report mortality after ingestion of at least 237 mL of an herbicide confirmed to contain both glyphosate and POEA. The decedent's electronic medical record indicates presentation to the emergency department shortly after ingestion and rapid decompensation, with death occurring on the fourth day of admission. The autopsy report showed extensive pulmonary edema and congestion with no alimentary tract abnormalities. Microscopically, airway inflammation, edema, and hemorrhage were shown as well as pericentral necrosis and macrovascular hepatic steatosis. This case is unusual for several reasons including the fatal outcome in a young 30-year-old patient, the large volume of the herbicide consumed, the associated large volume aspirated, and the lung pathology associated with exposure to glyphosate-POEA since inhalation, and in this case, aspiration is an uncommon route of glyphosate-POEA exposure. This report therefore offers rare respiratory tract pathological findings and the clinical course after aspiration of a large volume of glyphosate-POEA.

Language: en

Keywords

Humans; Adult; Male; Lung; Liver; Respiratory Insufficiency; Necrosis; Acute Kidney Injury; Herbicides; Glyphosate; Hemorrhage; Glycine; Liver Failure, Acute; Suicide, Completed; Pulmonary Edema; Edema; Polyethylene Glycols; Surface-Active Agents