Avermectin intoxication with coma, myoclonus, and polyneuropathy

Abstract

Introduction. Avermectin has been used in the control of parasites and insects. Severe poisoning symptoms in humans include altered mental status, hypotension, and respiratory failure. Case report. We describe a case of acute avermectin intoxication at a very high dose (414.2 mg/kg) who presented with coma, myoclonus, and polyneuropathy after oral ingestion. Discussion. The symptoms are supposed to be associated directly with the avermectin poisoning and possibly with the toxicity of solvents or other additives. Conclusion. To the best of our knowledge, this is the first case with avermectin poisoning associated with myoclonus and polyneuropathy in the literature.

Keywords:

• Avermectin
• Central nervous system
• Insecticide
• Peripheral nervous system
• Toxicity

Acknowledgments

The author thanks Hai-Tung Feng from Taiwan Agricultural Chemicals and Toxic Substances Research Institute for providing insecticide analysis and information and Dr. Chen-Chang Yang from Division of Clinical Toxicology, Taipei Veterans General Hospital for providing information.