Successful Treatment of Heart Failure Due to Simultaneous Poisoning with Aluminum Phosphide and Zinc Phosphide: A Case Report

Rodenticides are considered a global challenge to public health. Two major compounds in this category include aluminum phosphide and zinc phosphide. However, simultaneous use of aluminum phosphide and zinc phosphide has not been reported in the literature.
We present the case of a 20-year-old female, who was poisoned with both a rice tablet and powdered rat poison. She was admitted to Shahid Beheshti hospital of Babol University of Medical Sciences, Babol, Iran in July 2016. Resuscitative and supportive measures were applied, including prophylactic intubation, gastric lavage with a bicarbonate solution, and intravenous administration of N-acetylcysteine (NAC), magnesium sulfate, calcium gluconate, and bicarbonate compounds. In case of a blood sugar level above 100 mg/dL, regular insulin was infused. After the diagnosis of phosphine-induced cardiomyopathy, digitization with digoxin was prescribed for the patient.
This case report presents the possible positive effects of digoxin, insulin, and antioxidant therapy on simultaneous poisoning with aluminum phosphide and zinc phosphide.