Acute Zinc Phosphide Poisoning: Diagnosis and Management
Abstract
Zinc phosphide is a dark grey, crystalline compound. It is used as a rodenticide against such small mammals as mice, rats and squirrels. Upon ingestion, it gets converted to phosphine gas in the stomach, which is subsequently absorbed into the bloodstream through the stomach and the intestines and gets captured by the liver and the lungs. Phosphine gas inhibits cytochrome c oxidase which results in formation of highly reactive oxygen compounds leading to tissue injury, particularly those with a high oxygen demand (brain, lungs, liver, and kidney). Clinical symptoms are circulatory collapse, hypotension, shock symptoms, myocarditis, pericarditis, acute pulmonary edema, and congestive heart failure. Zinc phosphide poisoning is a significant cause of morbidity and mortality among socioeconomically low and especially in developing countries. The diagnosis of zinc phosphide poisoning depends on history, clinical examination and laboratory findings including ABG, liver and kidney functions,CBC and cardiac enzymes. Management of Zn3P2 is supportive and symptomatic as there is no specific antidote.