A Case of Zinc Phosphide-Induced Acute Fulminant Liver Failure

The use of rodenticides such as zinc phosphate is common in tropical countries. However, it has a toxic effect on humans when consumed or absorbed accidentally or deliberately. Although the adverse effects often only last for a short period, acute or fulminant liver failure can occur in few patients. Because the chemicals can create a wide variety of symptoms, it is essential to investigate the progression of symptoms from mild to severe so that treatment protocols can be understood and patients can receive appropriate care. In this report, we detail a case of rodenticide poisoning in a middle-aged man who, initially, had only minor symptoms but ultimately developed fulminant liver failure. In this example, we discuss the case of a 40-year-old man who intentionally consumed 10 gm of rat poison (zinc phosphide (ZnP)) and reported to our department with a complaint of nausea and three episodes of vomiting. A neurological evaluation showed that the patient had a Glasgow Coma Scale score of 9/15 (Eye(E): 2; Motor(M): 4; Verbal(V): 3). Doll's eyes were present, and the patient's pupils were semi-dilated, sluggishly reacting to light. The plantars were bilateral extensor. In the subsequent four hours, the patient developed a deep coma. The patient's lack of awareness, coagulopathy, and abnormal liver enzyme values all pointed to acute fulminant liver failure. His condition improved with supportive therapy over a period of three weeks.