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Life threatening central nervous system manifestations and hypothermia due to maneb intoxication in a child: a case

S M de Tollenaer1, Cmp Buysse, J N van den Anker

  • 1Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, the Netherlands. s.detollenaer@dog.azu.nl

Therapeutic Drug Monitoring
|December 14, 2006
PubMed

Insights

Maneb (manganese ethylene-bis-dithiocarbamate), a fungicide, caused severe neurological symptoms including status epilepticus in a child. This case highlights previously unreported central nervous system effects of maneb exposure.

Area of Science:

  • Environmental Toxicology
  • Neurotoxicology
  • Pediatric Toxicology

Background:

  • Maneb (manganese ethylene-bis-dithiocarbamate) is a widely used fungicide in agriculture and horticulture.
  • Known toxicological effects in humans include allergic reactions, central nervous system (CNS) effects, and renal toxicity.
  • Severe CNS effects, particularly status epilepticus, have not been previously documented in human maneb poisoning.

Observation:

  • A 7-year-old girl presented with status epilepticus, respiratory insufficiency, and severe hypothermia.
  • Initial diagnostic investigations, including toxicology screening for common substances, were normal.
  • Liquid chromatography-mass spectrometry detected maneb in the patient's blood, correlating with her symptoms.

Findings:

  • The patient experienced severe neurological symptoms, including intractable seizures and hypothermia, attributed to maneb exposure.
  • Despite the severity, all neurological signs resolved completely within 24 hours.
  • The patient recovered fully and was discharged within 72 hours.

Implications:

  • This case demonstrates that maneb can cause severe, acute central nervous system toxicity in humans, including status epilepticus.
  • The findings expand the known spectrum of maneb toxicity, particularly its neurotoxic potential.
  • Highlights the importance of considering less common pesticide exposures in pediatric emergencies with unexplained neurological symptoms.

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