Severe central nervous system depression in a patient with acute imidacloprid poisoning

Imidacloprid belongs to a relatively new class of insecticidal chemistry, the chloronicotinyl neonicotinoid compounds. We report a case of acute ingestion of an insecticide formulation containing imidacloprid. Clinical manifestations included respiratory failure and coma. A previously healthy 67-year-old male patient ingested an unknown quantity of imidacloprid for suicidal purpose. Disorientation, drowsiness, and increased salivation had developed by the time of arrival to a local hospital. On admission, his mental status was decreased (Glasgow Coma Scale score, 3/15). He was intubated and mechanically ventilated. Symptomatic and supportive treatments were given. At the fourth day, the patient was discharged from the hospital. None of the symptoms can be considered characteristic and specific for imidacloprid poisoning as a neonicotinoid compound. Although the symptoms can be resolved with supportive measures, none of them can be considered characteristic and specific for imidacloprid poisoning as a neonicotinoid compound.