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Published on: October 17, 2018
Rodenticide poisoning leading to cerebral hemorrhage: A case report
Qian-Kun He1, Yuan-Hua Wu1, Xiao-Ying Lu2
1Department of Neurology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Rationale:
Anticoagulant rodenticides (ARs) are a substantial fraction of murine types. AR poisoning causes bleeding from the skin, mucous membranes, and multiple organs. However, reports of AR-induced cerebral hemorrhage are scarce.
Patient Concerns:
A 40-year-old male presented with dizziness, headache, and limb weakness for 5 days and with coagulopathy. Two days prior to the onset of these symptoms, the patient was exposed to dead mice.
Diagnoses:
Rodenticide intoxication-induced cerebral hemorrhage.
Interventions:
Vitamin K1 infusion, administration of dehydrating agents to reduce intracranial pressure, and correction of acid-base and electrolyte imbalances.
Outcomes:
After 9 days of treatment, the patient's symptoms were relieved, and reexamination revealed that coagulation parameters returned to normal levels. The patient was eventually discharged for observation with oral vitamin K1.
Conclusions:
Rodenticide poisoning can lead to intracerebral hemorrhage, and treatment with vitamin K1 infusion is effective.
Lesson:
Rodenticide poisoning-induced cerebral hemorrhage is rarely reported. Because its symptoms are nonspecific, it is easy to miss the diagnosis or misdiagnose. When patients present with direct and indirect symptoms such as dizziness, headache, and limb weakness, rodenticide poisoning should be considered. Coagulation function and head computed tomography or magnetic resonance imaging examination should be performed at the earliest to confirm the diagnosis and provide timely treatment.
Insights
Anticoagulant rodenticide poisoning can cause rare but serious cerebral hemorrhages. Prompt diagnosis and treatment with Vitamin K1 infusion are effective for recovery.
Area of Science:
- Toxicology
- Neurology
- Internal Medicine
Background:
- Anticoagulant rodenticides (ARs) are common murine poisons.
- AR poisoning typically causes bleeding in various organs, but cerebral hemorrhage is seldom reported.
- This case highlights a rare manifestation of AR intoxication.
Observation:
- A 40-year-old male presented with neurological symptoms including dizziness, headache, and limb weakness, alongside coagulopathy.
- The patient reported exposure to dead mice prior to symptom onset.
- Initial symptoms were nonspecific, potentially leading to diagnostic challenges.
Findings:
- The patient was diagnosed with rodenticide intoxication-induced cerebral hemorrhage.
- Treatment involved Vitamin K1 infusion, management of intracranial pressure, and correction of metabolic imbalances.
- Neurological symptoms resolved, and coagulation parameters normalized after 9 days of treatment.
Implications:
- Rodenticide poisoning is a potential cause of intracerebral hemorrhage.
- Early consideration of rodenticide poisoning in patients with nonspecific neurological symptoms and coagulopathy is crucial.
- Vitamin K1 infusion is an effective treatment for rodenticide-induced cerebral hemorrhage, necessitating timely diagnosis through coagulation tests and neuroimaging.
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