Acute Oral Suicidal Intoxication with Captan—A Case Report

To the Editor:

Captan, 1,2,3,6‐tetrahydro‐n‐(trichloromethylthio) phthalimide, CAS number 133‐06‐2, RTECS GW 5075000 is a fungicide used widely in agriculture. Previous publications suggest an association between Captan and Non‐Hodgkin Lymphoma, as well as spontaneous abortion and congenital defects [1][2][3]. To the best of our knowledge there are no publications regarding acute poisoning with this fungicide in humans. A 17‐year‐old female with a history of depression was admitted to the Clinic of Toxicology with complaints of headache, nausea, weakness, numbness of upper limbs, and substernal pain. She indicated that these symptoms began three hours after the suicidal ingestion of 7.5 g of Captan 50 WP, which is a suspension of active ingredient Captan in a ratio of 50% mixed with water. In the clinic the patient was alert, temperature was 36.7°C, pulse 110–120/min, and BP 120–140/60–90 mmHg. Cardiac, pulmonary, abdominal, and neurological examinations were normal. WBC was slightly elevated (11,200/mm³) as was creatine kinase (309 U/L, normal up to 43 U/L) and aspartate aminotransferase (67 U/L, normal up to 29 U/L). ECG showed inversion of T waves in the III and aVF leads and echocardiogram was normal with an ejection fraction of 67%. After 72 hours of hospitalization all biochemical abnormalities resolved. The temporary increase of creatine kinase and aspartate aminotransferase activity as well as the presence of inverted T waves in III and aVF leads may suggest a cardiotoxic effect of Captan or other components of the Captan formulation during acute intoxication.