Fatal rodenticide poisoning with brodifacoum

摘要: The increased prevalence of rodents resistant to warfarin led the development hydroxycoumarin anticoagulant brodifacoum. A 25-year-old man attempted suicide by consuming four boxes d-CON Mouse-Prufe II; each box contains 42 g bait that is 0.005% He presented a hospital nine days later with syncope, hematochezia, gross hematuria, epistaxis, anemia, and severe coagulopathy. Radiographic studies were consistent pleural, pericardial, mediastinal hemorrhages. Vitamin K fresh frozen plasma given, he was discharged on oral phytonadione (vitamin K1). patient's coagulopathy recurred, necessitating multiple transfusions prolonged treatment phytonadione. Fifteen weeks after discharge, again history additional brodifacoum ingestion. Neurologic status initially normal, but in emergency department suddenly became comatose soon emesis induced syrup ipecac. Computed tomography brain revealed subarachnoid hemorrhage death less than 24 hours later. This case demonstrates can result from ingestion brodifacoum, compound has toxic potency about 200-fold half-life as much 60 times longer.