Chlorfenapyr Poisoning

 SUBSTANCE

-          C₁₅H₁₁BrClF₃N₂O (https://pubchem.ncbi.nlm.nih.gov/compound/Chlorfenapyr

-          a pyrrole insecticide

           

Common name / Trade name

-          Chlorfenapyr

 

Involving SYSTEM [1]

- CV: on the respiratory or cardiovascular systems

- ANS: autonomic nervous system and prominent neurotoxicity, dose-dependent.

- Muscle: skeletal muscle system, elevated CK.

- GI: gastrointestinal system: upset.

- blood coagulopathy. 

- Renal: elevated levels of blood urea nitrogen (BUN) and total protein.

- Deposited concentration ranked: 

  Fat, Large intestine, Blood, Liver, Muscle, Kidney, bone, brain, and lung. [2]. 

 

Presentation [1]

- Epidemiology: Age is 52.2±15.6 years old     

- Fever: the highest body temperature was 40.8±1.1 degrees Celsius.

- Consciousness: decrease in spontaneous motor activity, gait abnormality, and abnormal arousal.   

– Vital signs: Hyperthermia

- Neuro: salivation, convulsion, and death in large dose intoxication, bilateral leg weakness, and urinary incontinence.

- Rhabdomyolysis: the elevated CK level (4966±5978.4 IU/L)   

  - Metabolic acidosis

- Pancreatitis.    

 

Antidote / Treatment [1]

-          No specific antidote.

-          Early gastric decontamination 

-          Prolonged dialysis may be a possible method for preventing deterioration.

-          Effective supportive care.

 

Disposition

 

- The length of stay was 10.3±6.1 days.

- Initiation of fever and a deteriorating consciousness is the warning sign of a sudden fatal outcome.

- The mortality rate was up to 80%.        

 

REFERENCES

[1] Chien SC, Chien SC, Su YJ. A fatal case of chlorfenapyr poisoning and a review of the literature. J Int Med Res. 2022 Sep;50(9):3000605221121965. doi: 10.1177/03000605221121965. PMID: 36112969; PMCID: PMC9483958.

 [2]. https://pmc.ncbi.nlm.nih.gov/articles/PMC11153369/

 

Edited by Yu-Jang Su Sep 26, 2022. 

Revised. Feb 2, 2025.