Acute rotenone poisoning: A scoping review.

Area of Science:

• Toxicology
• Environmental Health
• Biochemistry

Background:

• Rotenone is a toxic chemical found in plants, posing a fatal poisoning risk with no antidote.
• It inhibits mitochondrial complex I, disrupting ATP production and causing oxidative stress.

Purpose of the Study:

• To review and analyze acute rotenone poisoning cases in humans.
• To understand exposure scenarios, clinical presentations, and available treatments.

Main Methods:

• A literature search was conducted across five databases up to July 12, 2022.
• 11 case reports involving 18 victims were identified and analyzed for exposure details, clinical features, and outcomes.

Main Results:

• 15 out of 18 victims were hospitalized, and five died.
• Vomiting and metabolic acidosis were common; some patients experienced cardiopulmonary dysfunction.
• Supportive treatments included gastric lavage, activated charcoal, vasopressors, mechanical ventilation, sodium bicarbonate, and N-acetylcysteine.

Conclusions:

• Rotenone poisoning is rare but potentially fatal, with challenging exposure prevention.
• Under-diagnosis may occur due to non-specific symptoms and under-reporting.
• Supportive care is the current treatment; antioxidant therapy warrants further investigation in animal models.