Cypermethrin poisoning manifesting with prolonged bradycardia: A case report

Graphical abstract

Highlights

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  Cypermethrin poisoning can present as a medical emergency with neurological, gastrointestinal or cardiac manifestations.

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  Prolonged bradycardia following acute oral intoxication with cypermethrin is a rare entity.

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  In view of the absence of antidote, conservative management has been found effective in prolonged bradycardia induced by cypermethrin toxicity.

Abstract

Pyrethrins and their synthetic derivatives known as pyrethroids are highly effective insecticides used worldwide in the agricultural fields and households. Cypermethrin is a type II pyrethroid which acts primarily by delaying the closure of voltage-sensitive sodium channels at higher concentrations. Its toxicity in humans occur due to accidental or intentional exposure through inhalation, skin contact or via ingestion. Acute oral intoxication of cypermethrin commonly manifests with neurotoxic and gastrointestinal effects in humans. Cardiotoxic effects following ingestion of this compound have occurred in a few cases but underreported to date. This case highlights a case of intentional cypermethrin poisoning with acute effects in the form of prolonged bradycardia symptomatically managed with a muscarinic antagonist like atropine sulphate.