Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child

Resmethrin, a type I pyrethroid insecticide, can activate sodium channels, causing neurotoxicity in both mammals and insects. Possible routes of poisoning include inhalation, dermal contact and ingestion. There are no specific symptoms for resmethrin poisoning. Until now, no antidote has been availa...

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Autores principales:	Lilin Huang, Shumei Peng, Ronghan Li, Dongping Huang, Danyu Xie
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	resmethrin poisoning neurotoxicity neuroimaging child pyrethroid Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/d9ed4e222a794ae09b06033df6bd6c3a
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spelling	oai:doaj.org-article:d9ed4e222a794ae09b06033df6bd6c3a2021-11-19T05:10:07ZCase Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child2296-236010.3389/fped.2021.746950https://doaj.org/article/d9ed4e222a794ae09b06033df6bd6c3a2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.746950/fullhttps://doaj.org/toc/2296-2360Resmethrin, a type I pyrethroid insecticide, can activate sodium channels, causing neurotoxicity in both mammals and insects. Possible routes of poisoning include inhalation, dermal contact and ingestion. There are no specific symptoms for resmethrin poisoning. Until now, no antidote has been available for resmethrin. Resmethrin poisoning is rarely reported in children. Here, we report a fatal case of resmethrin poisoning that might have been caused by accidental ingestion by a 26-month-old child. He presented with neurotoxic symptoms that included vomiting, recurrent seizures, and coma. The cranial CT showed extensive lesions of low intensity in the bilateral white matter, thalamus, brainstem, and cerebellum. Lumbar punctures showed increased intracranial pressure (ICP > 25 mmHg). Cerebrospinal fluid (CSF) tests revealed that protein was elevated to 289.2 mg/dL without pleocytosis. Resmethrin was detected in his blood by liquid chromatography-mass spectrometry, which confirmed the diagnosis of resmethrin poisoning. The child developed brain stem herniation and then was declared brain dead at the 77th h after admission. Resmethrin poisoning can be fatal, and it requires immediate diagnosis and treatment. Previous studies reported that cranial CT and CSF analyses were all normal in patients with pyrethroid poisoning. This case might extend the knowledge of neuroimaging and CSF analysis in children with resmethrin poisoning.Lilin HuangShumei PengRonghan LiDongping HuangDanyu XieFrontiers Media S.A.articleresmethrin poisoningneurotoxicityneuroimagingchildpyrethroidPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	resmethrin poisoning neurotoxicity neuroimaging child pyrethroid Pediatrics RJ1-570
spellingShingle	resmethrin poisoning neurotoxicity neuroimaging child pyrethroid Pediatrics RJ1-570 Lilin Huang Shumei Peng Ronghan Li Dongping Huang Danyu Xie Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
description	Resmethrin, a type I pyrethroid insecticide, can activate sodium channels, causing neurotoxicity in both mammals and insects. Possible routes of poisoning include inhalation, dermal contact and ingestion. There are no specific symptoms for resmethrin poisoning. Until now, no antidote has been available for resmethrin. Resmethrin poisoning is rarely reported in children. Here, we report a fatal case of resmethrin poisoning that might have been caused by accidental ingestion by a 26-month-old child. He presented with neurotoxic symptoms that included vomiting, recurrent seizures, and coma. The cranial CT showed extensive lesions of low intensity in the bilateral white matter, thalamus, brainstem, and cerebellum. Lumbar punctures showed increased intracranial pressure (ICP > 25 mmHg). Cerebrospinal fluid (CSF) tests revealed that protein was elevated to 289.2 mg/dL without pleocytosis. Resmethrin was detected in his blood by liquid chromatography-mass spectrometry, which confirmed the diagnosis of resmethrin poisoning. The child developed brain stem herniation and then was declared brain dead at the 77th h after admission. Resmethrin poisoning can be fatal, and it requires immediate diagnosis and treatment. Previous studies reported that cranial CT and CSF analyses were all normal in patients with pyrethroid poisoning. This case might extend the knowledge of neuroimaging and CSF analysis in children with resmethrin poisoning.
format	article
author	Lilin Huang Shumei Peng Ronghan Li Dongping Huang Danyu Xie
author_facet	Lilin Huang Shumei Peng Ronghan Li Dongping Huang Danyu Xie
author_sort	Lilin Huang
title	Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
title_short	Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
title_full	Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
title_fullStr	Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
title_full_unstemmed	Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
title_sort	case report: fatal neurotoxicity following resmethrin poisoning in a child
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/d9ed4e222a794ae09b06033df6bd6c3a
work_keys_str_mv	AT lilinhuang casereportfatalneurotoxicityfollowingresmethrinpoisoninginachild AT shumeipeng casereportfatalneurotoxicityfollowingresmethrinpoisoninginachild AT ronghanli casereportfatalneurotoxicityfollowingresmethrinpoisoninginachild AT dongpinghuang casereportfatalneurotoxicityfollowingresmethrinpoisoninginachild AT danyuxie casereportfatalneurotoxicityfollowingresmethrinpoisoninginachild
_version_	1718420404819722240

Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child

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