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Taking the bait: Strychnine poisoning
Jeremy Hardin1, Henrik Galust1, Alexandra Bensel2
1Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, CA; VA San Diego Healthcare System, San Diego, CA, United States of America; San Diego Division, California Poison Control System, San Diego, CA, United States of America.
The American Journal of Emergency Medicine
|October 7, 2023
Summary
This case report details a rare strychnine poisoning from ingesting "gopher killer." The patient experienced severe muscle spasms and cardiovascular collapse but recovered fully after intensive treatment.
Area of Science:
- Toxicology
- Emergency Medicine
- Neurology
Background:
- Strychnine poisoning is a rare but life-threatening condition.
- Intentional ingestion of pesticides containing strychnine poses a significant public health risk.
Observation:
- A 48-year-old male presented with generalized muscle spasms, opisthotonos, and cardiovascular collapse after ingesting strychnine-based pesticide.
- Classic neurological and physical examination findings consistent with strychnine toxicity were observed.
- A blood strychnine concentration of 2.2 mg/L was recorded five hours post-ingestion.
Findings:
- The patient required 24 hours of neuromuscular paralysis for management of severe muscle spasms.
- Despite the severity of poisoning, the patient was discharged on hospital day 10 without any long-term sequelae.
- This case highlights the potential for recovery even in severe strychnine poisoning with appropriate medical intervention.
Implications:
- This case underscores the importance of recognizing and managing rare toxicological emergencies.
- The report includes a video of classic strychnine poisoning findings, serving as a valuable educational tool for clinicians.
- Public awareness regarding the dangers of pesticide ingestion is crucial to prevent such incidents.
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