Acute Pancreatitis, Hepatitis and Bone Erosion in Acute Yellow Phosphorous Compound Poisoning - A Rare Complication

Prabhakar Kamarthi1, Parimala Subramani2, Arun Vardharaju Gopu3

  • 1Professor, Department of Medicine, Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka, India .

Insights

Yellow phosphorus ingestion caused acute pancreatitis, hepatitis, and nasal septum erosion. Fungal infections, Aspergillus flavus and Candida tropicalis, were identified and treated successfully with fluconazole.

Area of Science:

  • Toxicology
  • Mycology
  • Gastroenterology

Background:

  • Yellow phosphorus poisoning is a rare but severe condition.
  • Acute pancreatitis and hepatitis are known complications of toxic ingestions.
  • Nasal septum erosion can occur in severe systemic illnesses.

Observation:

  • A patient presented with acute pancreatitis and hepatitis after ingesting yellow phosphorus.
  • The patient developed encephalopathy and significant bony erosion of the nasal septum.
  • Endoscopic examination revealed fungal masses in both nasal cavities.

Findings:

  • Microbiological investigations identified Aspergillus flavus and Candida tropicalis as the causative fungi.
  • The patient's clinical condition improved following treatment with fluconazole.

Implications:

  • This case highlights the potential for severe systemic and local complications from yellow phosphorus ingestion.
  • It underscores the importance of considering opportunistic fungal infections in immunocompromised or critically ill patients.
  • Antifungal therapy can be effective in managing such secondary infections.

Related Concept Videos

Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
1.9K
Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
116
Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.4K
Physical Properties of Amines01:26

Physical Properties of Amines

Amines with low molecular weight are usually gaseous at room temperature, while those with high molecular weight are liquid or solids in nature. Usually, low molecular weight amines have a rotten fish-like smell. Diamines typically have a pungent smell. For instance, cadaverine and putrescine, depicted in Figure 1, are two molecules responsible for decaying tissue.
4.4K
Antidotes01:17

Antidotes

Antidotes are medicinal substances used to counteract the harmful effects of toxins or drugs in the body. They function in various ways, each uniquely designed to combat specific toxic compounds.
Specific antidotes operate by inhibiting the enzymes that control biochemical pathways, reducing the production of harmful metabolites.
An example of an antidote is atropine, which counteracts the detrimental effects of cholinesterase inhibitors. It achieves this by deactivating muscarinic receptors,...
1.3K
Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
54