Case report of Acetamiprid poisoning with Turquoise vomitus

Introduction 

Acetamiprid belongs to a new systemic neonicotinoid insecticide that is effectively used for crop protection and flea control in agricultural works []. It has low toxicity in mammals, but ingestion of large amounts can cause severe toxicity. It is described in a case report that a buffalo exhibited severe gastrointestinal symptoms and respiratory distress following accidental ingestion of acetamiprid in India []. Here we describe a case of a 34 year old male with diabetic ketoacidosis and acetamiprid ingestion 

Case Report 

This is the case of a 34 year old male who is a resident of Nalgonda m, Telangana , who is a farmer by occupation , was brought to the casuality at 6:00am with history of Acetamipride 20% (insecticide) ingestion approximately 50gm powder in 2 glasses of water , he presented with 3 episodes of turquoise colored vomitus and shortness of breath since 1:00am  




There is n/h/o pain abdomen , giddiness , nausea , chest pain , palpitations , incontinence and  feces . 

The patient is a known case of Diabetes Mellitus type 2 since 1 year , never used medication . 

General examination 

patient was c/c/c GCS 15/15 

vitals - 

-RR : 22 CPM

-HR : 88 BPM 

-BP : 110/80 mmHg

-SpO2 : 98 on room air 

-GRBS : 453 mg/dl 

- urine for ketone bodies ++

ABG 

-pH : 7.242 

-pCo2 : 23.1mmHg 

-pO2 : 101mmHg 

-HCO3 : 9.6mmol/L 

-Base excess : 16.3 mmol/L

-Anion gap : 26 mEq/L 

RFT 

urine output - >0.5ml/kg/hr 

urea - 19mg/dl 

creatinine - 1.2 mg/dl 

LFT 

TB : 1.27 mg/dl 

DB : 0.30 mg/dl 

AST : 82IU/L

ALP :  152IU/L 

ALT : 32IU/L 

TP : 7.7 GM/DL 

ALB : 4.3 MG/DL 

-Diabetic ketoacidosis (High anion gap Metabolic acidosis )













 










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