Intentional Poisoning with the Pyrethroid Compound Cyfluthrin: A Unique Case of Fly-Repellent Spray Ingestion

Abstract

Given that insect repellents and insecticides containing pyrethroids are commonly used in the home, cases of poisoning are not uncommon. Acute pyrethroid poisoning in humans usually occurs by skin-to-skin contact, inhalation of spray products or by oral ingestion. This case report presents a patient who ingested cyfluthrin, a pyrethroid compound, from an aerosol by liquefaction.Synthetic pyrethroid compounds are widely used for their insecticidal/insect repellent properties, but are considered to be less toxic to humans. However, caution should be exercised when these substances cause poisoning in humans, especially potent ones such as cyfluthrin, as this compound is found in the structure of many household products. Although some patients present with mild symptoms, some patients may present with severe, life-threatening clinical signs such as respiratory distress and coma. treatment is often symptomatic. Our patient had attempted suicide with a fly repellent spray when he presented to the emergency department. Physical examination revealed bilateral mydriatic pupils, bilateral positive light reflex and increased salivation. Laboratory findings including cholinesterase were normal. Atropine was administered and the patient was discharged with recovery. Treatment is mainly symptomatic and there is no specific antidote. Although washing the skin with soapy water is recommended, there is no evidence that this reduces toxicity. Emergency services should be alert to this type of poisoning.