Case Report

Aluminum Phosphoide Suicidality in Serious Toxicity Passing the Death with Hydrocortisone Superiority, A Case Report

Yasser Mohammed Hassanain Elsayed
Critical Care Unit, Fraskour Central Hospital, Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt

Worldwide Medicine 2019; 1(7): 236-242 | DOI: 10.5455/ww.55853      PDF


Abstract


Rationale: Aluminum phosphide (AlP) is an extremely lethal toxic pesticide. Unfortunately, its suicidal use has become more widespread. Aluminum phosphide ingestion is usually suicidal, uncommonly accidental, and rarely homicidal. Severe toxicity of multiple major organs is very common. Patient concerns: A 17-year-old female patient presented at the emergency department with suicidal attempt after voluntary oral intake of around 1.875 gm of aluminum phosphide. The patient presented with multisystemic serious toxicity of cardiovascular, adrenocortical, hematological, hepatic, and metabolic affections. The patient was admitted to the critical care unit and was managed primarily with an aggressive regimen of parenteral hydrocortisone therapy in addition to fluids and supportive therapy. Diagnosis: Aluminum phosphide toxicity Interventions: Rapid decontamination, resuscitative measures, electrocardiography, central venous pressure, clinical, and serial laboratory monitoring. Outcomes: The complete recovery was achieved by rescuing the toxic effects of aluminum phosphide in the body major organs. Lessons: The clinical impact of this case highlighted the role of parenteral hydrocortisone therapy throughout its management course. Parenteral hydrocortisone therapy was life-saving in the management of acute aluminum phosphide toxicity. Keywords: Multisystemic toxicity, Aluminum Phosphide suicidality, Serious toxicity, Passing the death, Hydrocortisone superiority.