Citation

Nogué S, Sanz P, Borondo JC, Picón M, de la Red G, Mestre G. Acta Anaesthesiol. Scand. 2003; 47(6): 777-779.

Copyright

(Copyright © 2003, Acta Anaesthesiologica Scandinavica Foundation, Publisher John Wiley and Sons)

DOI

10.1034/j.1399-6576.2003.00122.x

PMID

12803600

Abstract

A 66-year-old-male patient with a history of depression voluntarily ingested around 400 ml of an insecticide composed of 5% methylparathion, 75% isoparaffin, 8% etoxylated oleic acid, 4% 1,2,4-trimethylbenzene, 6% naphtha, 1% 1,3,5- trimethylbenzene, 0.4% propylbenzene and 0.3% xylene. The patient was conscious and alert at admission. Gastric lavage was performed and activated charcoal administered. There were no clinical symptoms of organophospate ingestion despite reduced concentrations of erythrocyte and plasma cholinesterase. Chest X-ray showed pulmonary infiltrate compatible with bronco-aspiration. The patient evolved to respiratory failure refractory to treatment and died from multiorganic failure 23 days after ingesting the insecticide. The pathological findings included a pulmonary fibrosis in the alveolar spaces which caused enlargement of the intra-alveolar septa. Abundant lipin-laden macrophages were observed within the alveolar spaces. We review the most relevant aspects of cases of fatal lipoid pneumonia and point out that on occasion severe or fatal intoxication is due to the substances accompanying the active ingredients.

Language: en

Keywords

Aged; Depression; Fatal Outcome; Gastric Lavage; Humans; Insecticides; Lung; Male; Multiple Organ Failure; Organophosphorus Compounds; Paraffin; Pneumonia, Aspiration; Pneumonia, Lipid; Pulmonary Alveoli; Pulmonary Fibrosis; Respiratory Insufficiency; Suicide