Acute toxic encephalopathy induced by chloropicrin: case report

Chloropicrin is commonly utilized as a pesticide to fumigate soil against insects, fungi, and nematodes. As a highly toxic chemical substance, chloropicrin can cause irritation and toxic reactions at the site of contact. Current literature primarily focuses on reporting its toxic effects in human eyes, respiratory system and skin. Cases of toxic encephalopathy induced by chloropicrin remain exceedingly rare in the medical literature.

A 53-year-old male developed impaired consciousness after exposure to chloropicrin, then he was admitted to the emergency department. After ruling out systemic diseases, cerebrovascular disorders, intracranial infections, and immune-mediated diseases, he was diagnosed with toxic encephalopathy induced by chloropicrin. Supportive treatment and the application of antioxidants and hyperbaric oxygen therapy were given to the patient. After 3 weeks, his consciousness improved, and he was discharged to home.

We report a case of toxic encephalopathy induced by chloropicrin, and the patient only exhibited mild signs of acute respiratory distress syndrome (ARDS), which cannot explain his state of mental disorder. Although his head magnetic resonance imaging (MRI) was generally normal, the electroencephalography (EEG) supported the diagnosis of toxic encephalopathy. Through this case report and literature review, we aim to emphasize the need for enhanced protective measures among agricultural workers during production processes. Additionally, we seek to raise awareness among healthcare professionals regarding chloropicrin-induced toxic encephalopathy, advocating for timely diagnosis and effective management of poisoning exposures to improve patient outcomes.