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Dermal exposure to strychnine.

R Greene¹, R Meatherall

¹Emergency Department, Grace General Hospital, Winnipeg, Manitoba, Canada.

Journal of Analytical Toxicology

|August 14, 2001

Summary

This summary is machine-generated.

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A woman experienced non-fatal strychnine poisoning via skin contact after a spill. Symptoms included muscle pain and jaw stiffness, with elevated creatine kinase and myoglobin indicating rhabdomyolysis.

Area of Science:

Toxicology
Dermatology

Background:

Strychnine poisoning is typically associated with ingestion or inhalation.
Dermal exposure is a less common route but can lead to systemic toxicity.

Observation:

A 50-year-old woman presented with symptoms consistent with strychnine poisoning 24 hours after dermal exposure to a strychnine spill.
Clinical signs included lower limb muscle pain, dermal sensitivity, and jaw stiffness.
Elevated plasma creatine kinase (677 U/L) and serum myoglobin (195 µg/L) suggested rhabdomyolysis.

Findings:

Strychnine was detected in plasma (196 ng/mL) and urine (6,850 ng/mL) via gas chromatography-mass spectrometry.
Treatment involved intravenous fluid replacement and alkalinization to prevent renal failure.
A minor, likely inconsequential, level of pheniramine was also detected.

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Implications:

This case highlights the potential for systemic toxicity from dermal strychnine exposure.
Early recognition and supportive treatment are crucial for managing non-fatal strychnine poisoning.
Monitoring for rhabdomyolysis and potential renal complications is important in affected individuals.