A case of self poisoning with imidacloprid leading to severe psychiatric symptoms

We are reporting a case of self poisoning with imidacloprid leading to severe psychiatric symptoms and respiratory failure. A forty one year male patient was brought to emergency with alleged history of self ingestion of 75ml 70% imidacloprid three hours before admission. He had developed nausea, vomiting, abdominal cramps, muscle twitching and difficulty in breathing within 30 minutes of ingestion of poison. He was immediately resuscitated with endotracheal intubation and ventilated with ambu bag. After 12 hours of ventilation the patient was fully conscious and started developing neuropsychiatric manifestations like agitation and delirium. Due to severe agitation he self extubated so he was sedated and reintubated. After 96 hours, neuropsychiatric manifestations subsided and he was weaned off from the ventilator and extubated on day five.

Source: Kishor Viradiya, Ajay Mishra (2011) JAPI 59:594-595 (attached)