Case Report: Disseminated Cysticercosis due to Intentional Ingestion of Parasitic Worm Eggs for Weight Loss

A 20-year-old female resident of Beijing intended to consume the eggs of the parasitic worm, Taenia saginata, for weight loss; however, she apparently inadvertently ingested Taenia solium (pork tapeworm) eggs, which resulted in disseminated cysticercosis. Cysticerci developed in the brain, tongue, muscles, liver, peritoneum, and subcutaneous tissues. She was administered oral albendazole and praziquantel. After four 10-day courses of treatment, most of the cysts disappeared and she recovered. After 3 years, the patient remains in good health.

Non-suicidal intentional ingestion of iron tablets and severe intoxication: the result of adolescent boy’s impulsive risky behaviour in the school

Acute iron poisoning is a potentially fatal intoxication in children. As the Iron preparations are commonly administered to pregnant women, lactating mothers, toddlers, it is easily available at home. So younger children are prone to consume it accidently. Although iron is a therapeutic drug in recommended dosages, excessive iron in the free state can produce toxicity by affecting multiple cellular processes by catalysing redox reactions with lipid peroxidation and free radical formation. The severity of intoxication depends on the amount of elemental iron ingested. Serious toxicity is usually associated with a dose of >40 mg/kg of elemental iron. Levels more than 100 mg/kg are almost always fatal. We report a case where a 12-year male child intentionally taken 60 tablets of iron (ferrous fumarate) at his school as a part of competition or bet to other schoolmate and presented with acute iron poisoning with hepatic encephalopathy to us. Important initial laboratory parameters were AST-4,879 U/L, Prothrombin time-60 sec and Iron level-213 microgram/dl. With timely specific management i.e., deferoxamine infusion along with all required intensive care supportive management in PICU the patient was discharged successfully. We chose to report this case to highlight the risky behaviour of adolescence who usually grows physically and emotionally earlier but their prefrontal lobes are yet immature to take proper and correct decision. Thus, impulse activity may prove fatal for them.

Anticoagulant rodenticide ingestion: Who will develop coagulopathy?

Introduction: Development of coagulopathy after anticoagulant rodenticide ingestion varies among patients. This study aimed to identify factors that were associated with coagulopathy after anticoagulant rodenticide ingestion. Methods: This was a retrospective cohort study, conducted in the Hong Kong Poison Information Centre. All patients who reported rodenticide exposure and presented to the Accident and Emergency Department from 1 January 2010 to 31 December 2019 were recruited. Coagulopathy was defined as International Normalized Ratio of 1.3 or above. Results: One hundred sixty-nine patients were included in the final analysis. The median age was 44 years old. Forty-nine patients developed coagulopathy (International Normalized Ratio ⩾1.3). Univariate analysis (at p < 0.05) showed that age (p = 0.003), ingestion of first-generation anticoagulant rodenticide (p = 0.017), ingestion of more than one pack (p < 0.001), intentional ingestion (p = 0.002), hypoalbuminemia (p < 0.001), elevated alanine aminotransferase level (p = 0.041) and abnormal estimated glomerular filtration rate (p = 0.005) on presentation, and co-ingestion with paracetamol (p = 0.018) were associated with coagulopathy after anticoagulant rodenticide ingestion. Among these, ingestion of more than one pack (p < 0.001; odds ratio = 19.8; 95% confidence interval = 6.78–65.7), ingestion of first-generation anticoagulant rodenticide (p = 0.006; odds ratio = 5.2; 95% confidence interval = 1.96–15.2), hypoalbuminemia (p < 0.001; odds ratio = 22.4; 95% confidence interval = 6.17–99.0) and elevated alanine aminotransferase level on presentation (p = 0.039; odds ratio = 7.11; 95% confidence interval = 1.58–33.1) were statistically significant in the multivariate analysis. Conclusion: Ingestion of more than one pack and ingestion of first-generation anticoagulant rodenticides were significantly associated with the development of coagulopathy after anticoagulant rodenticide ingestion. Patients who developed hypoalbuminemia or elevated alanine aminotransferase level as a result of anticoagulant rodenticide ingestion were also significantly associated with the development of coagulopathy.

Potential Source of Heavy Metals in the Geophagic Clay (Marl) and Its Implication on Human Health in NE Iraq: A Pilot Study

Geophagy is the eating of non-food earthy matters practice (such as clay), which is performed especially in humans, to augment a scanty or mineral-deficient diet or as part of a cultural tradition. Geophagy, the intentional ingestion of clay or soil, is a prevalent practice among animals and humans, especially is more common in young ages, such as children and among pregnant women with a young age. In spite of some well documented cases, the motivations of this practice and its consequences on the status of health of the consumer are still unclear. This study focused on the source of heavy metals and its health impact because of the importance of the topic in the environmental hazards, especially as this addictive phenomenon may not be well known among families in our societies. During this study, twenty-four samples of marl were collected within the rock sequences of the Fatha Formation in the Kirkuk and Diyala, which are used in eating (mud eating disease) in these regions. The samples were subjected to laboratory studies including chemical analyses, to determine their contents of trace elements. The laboratory analytical data showed that these muds (marl) contain different concentrations of chemical elements such as (Co, Cr, Ni, Cu, and Zn) which are among the heavy toxic elements and harmful to human health. A close look at the analytical data and results of the statistical and environmental factors, it is found that the marl (geophagia) consumption in terms of its content of trace elements, poses health risks to the consumer. However, it is worth mentioning to say that Geophagia practice may contribute large levels of the most beneficial elements such as Ca, Fe, K, Na, Cu, and Zn, supplying in demand mineral nutrients in the human body.

Intentional ingestion of batteries and razor blades by a prisoner: a true emergency?

Purpose Few case studies in the literature report on adult patients with intentional foreign body ingestion. Prisoners deliberately ingest foreign bodies, such as cylindrical alkaline batteries and razor blades, to achieve hospitalization or commit suicide. The purpose of this paper is to present a case of deliberate ingestion of batteries and razor blades by an inmate. Design/methodology/approach The authors present a case of an incarcerated man in Greece, who intentionally ingested three cylindrical alkaline batteries and three razor blades wrapped in aluminum foil. Findings The patient was treated conservatively with serial radiographs and was subsequently discharged without complication. This paper discusses the complications and examine the current guidelines available. Originality/value To best of authors’ knowledge, this is the first report of a simultaneous ingestion of batteries and razor blades.

Rapid Glomerulotubular Nephritis as an Initial Presentation of a Lethal Diquat Ingestion

Introduction. Diquat is an herbicide that can lead to rapid multiorgan system failure upon toxic ingestion. Although Diquat shares a similar chemical structure with paraquat, diquat is still readily available to the general population, and in contrast to paraquat, it is not regulated. We present a case of an intentional diquat poisoning which emphasizes the necessity of the early recognition due to atypical symptoms within the first 24 hours and certainly enhanced regulatory restrictions on this very toxic compound. Case. A 60-year-old male with a history of severe depression presented to the emergency department after intentional ingestion of a commercial herbicide containing diquat dibromide 2.30%. The earliest manifestations of this acute diquat intoxication comprised a glomerulonephritis and proximal tubular dysfunction. Progressive multiorgan system failure then developed with a significant delay (24–38 hours) including acute renal, liver failure, and then respiratory failure with refractory hypoxemia. Despite maximal supportive care, the end organ failure was lethal. Discussion. Diquat intoxication should be suspected in patient presenting an acute glomerulonephritis with coma. Diquat should undergo the same regulatory restrictions as paraquat-containing compounds.