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Intravenous thiodan (30% endosulfan in xylene)
W G Grimmett1, I Dzendolet, I Whyte
1Queensland Flying Obstetric & Gynaecological Service, Roma, Australia.
Journal of Toxicology. Clinical Toxicology
|January 1, 1996
Summary
This case study details the first reported instance of intravenous Thiodan (endosulfan) self-poisoning. A small dose caused severe seizures, rhabdomyolysis, and organ dysfunction, but the patient recovered with supportive care.
Area of Science:
- Toxicology
- Neuroscience
- Emergency Medicine
Background:
- Endosulfan, an organochlorine insecticide, is typically associated with oral or dermal poisoning.
- Intravenous administration of pesticides is rare and poses unique toxicological challenges.
Observation:
- A 28-year-old female with epilepsy presented with refractory grand mal seizures after intentional intravenous injection of Thiodan (30% endosulfan in xylene).
- Clinical manifestations included severe seizures, rhabdomyolysis-induced myopathy, liver dysfunction, and acute renal failure.
Findings:
- Seizures were controlled with midazolam and thiopentone; mechanical ventilation was required for nine days.
- Renal and liver dysfunction resolved with supportive care; hemodialysis was not needed.
- The patient experienced minimal pulmonary complications and neurological sequelae, achieving full recovery within three months.
Implications:
- Intravenous endosulfan, even in small doses, can rapidly induce severe neurological and systemic toxicity.
- The absence of pulmonary edema suggests that aspiration is a primary mechanism for pulmonary toxicity in oral endosulfan poisoning, distinct from intravenous routes.