Introduction Dichlorvos-based insecticides intended for agricultural and professional pest control, including Sniper® and Lava®, are increasingly used indoors for mosquito control in urban areas of the Democratic Republic of Congo.Methods We reviewed calls to the Lubumbashi Poison Control Centre and clinical reports from health facilities in Kinshasa and Kolwezi concerning acute symptoms after domestic use of Sniper® or Lava®. Cholinesterase activity was not measured.Results Between 7 December 2025 and 25 February 2026, 22 cases of possible poisoning after indoor spraying were reported: 7 by telephone in Lubumbashi, 12 in Kinshasa (11 admitted to hospital), and 3 in Kolwezi (all admitted). Symptoms included dizziness, headache, nausea, and dyspnea. Products were often applied at night with improvised spray containers in poorly ventilated rooms. Symptoms were generally mild to moderate, although one patient in Kinshasa presented with coma. All admitted patients recovered.Discussion The symptoms are consistent with possible acute organophosphate exposure, but the absence of cholinesterase measurements limits confirmation. Unsafe application practices, limited risk awareness, and unrestricted product availability may contribute to exposure.Conclusion This case series highlights the need to reduce household exposure, improve risk communication and poisoning surveillance, and strengthen regulatory oversight.
Introduction Reports of hydrocarbon aspiration pneumonitis are infrequent. In addition, delayed complications are uncommon but recognised in the literature.Case A 25-year-old male fire breather accidentally aspirated unlit naphtha hydrocarbon fuel during a performance. He developed cough, dyspnoea, chest pain, epigastric pain, vomiting, and diarrhoea, and was diagnosed with aspiration pneumonitis and mild oesophageal injury. Treatment with intravenous antibiotics and steroids led to clinical improvement and discharge within 1 week. Eighteen days after the initial exposure, he re-presented to the hospital with haemoptysis, fever, dyspnoea, and worsening chest pain. Computed tomography demonstrated pulmonary abscesses with necrotising features. He was re-commenced on intravenous antibiotics and had significant analgesic requirements. Percutaneous drainage was considered but ultimately not required. He achieved full clinical recovery following a prolonged course of antibiotic therapy.Discussion This case highlights how delayed biphasic deterioration may occur despite apparent early recovery after hydrocarbon aspiration and suggests non-invasive management may be feasible in selected, closely monitored patients with an improving clinical trajectory.
Introduction Abamectin is a macrocyclic lactone pesticide causing central nervous system depression and respiratory or cardiovascular instability. Evidence for extracorporeal treatment, particularly hemoadsorption, remains limited.Case A 62-year-old man with cerebral infarction intentionally ingested 50 mL of 3.6% abamectin pesticide (Reasgant 3.6EC). LC-MS/MS confirmed exposure. Five hours after ingestion, he developed consciousness impairment (GCS 6; E1V1M4), bilateral mydriasis (5 mm), sinus bradycardia, and hypotension (90/60 mmHg), with heart rate reaching 30 beats/min. Atropine and adrenaline were administered. MRI showed chronic cerebral infarction, and echocardiography was normal. Troponin T increased from 27.9 to 44.5 ng/L, while NT-proBNP peaked at 140.2 pg/mL. Hemoadsorption with an MG-350 cartridge was initiated 18 hours after ingestion, using 200 mL/min blood flow, 2–3-hour sessions, heparin anticoagulation, and a cartridge per session for three sessions. GCS improved from 6 to 9, followed by recovery. He was discharged after 10 days without sequelae.Discussion Hemoadsorption may have contributed to improvement, but causality cannot be established because serial abamectin concentrations were not measured. Further studies are warranted.
Background Acute colonic pseudo-obstruction (Ogilvie syndrome) is a rare but serious condition characterized by marked colonic dilatation without mechanical obstruction. Anticholinergic medications, including tricyclic antidepressants, have been implicated as potential causes.Case report We report a 64-year-old man who intentionally ingested approximately 2,500 mg of amitriptyline. Eleven hours later, he presented with depressed consciousness and anticholinergic manifestations. On hospital day 5, he developed progressive abdominal distension and obstipation. Computed tomography demonstrated marked bowel dilatation without a definite mechanical obstruction. Due to progressive bowel dilatation despite conservative management, exploratory laparotomy and decompressive cecostomy were performed. Postoperatively, the patient developed septic shock and multiorgan dysfunction requiring vasopressor support and continuous renal replacement therapy. He subsequently recovered and was discharged in stable condition.Discussion Amitriptyline overdose may cause severe gastrointestinal hypomotility resulting in acute colonic pseudo-obstruction. Clinicians should recognize this uncommon complication when evaluating patients with abdominal distension after tricyclic antidepressant poisoning.
Background Postmortem vitreous chemistry is an understudied analytical test in marine mammals.Methods We assessed the analytical precision of pooled common bottlenose dolphin vitreous humor (VH) samples using the Heska Corporation Element DC chemistry analyzer and to examine the short-term stability of pooled VH when stored at room temperature and in a hot environment (inside a vehicle).Results The within-run and between-run CVs for all detectable analytes were <20%, with most <5%, indicating acceptable repeatability within the pooled matrix. At room temperature, Ca and Mg had statistically significant decreases over the 4-hour period, and in the hot vehicle condition, Ca had a statistically significant decrease over the same period. Potassium and glucose concentrations were outside the instrument's reportable range, representing a limitation for postmortem interpretation.Conclusion These results from this proof-of-concept feasibility study demonstrate that the Element DC chemistry analyzer can produce repeatable measurements in a pooled dolphin VH matrix. Further studies are required to evaluate the applicability of this platform including analytical accuracy, matrix effects, or performance in individual postmortem samples under real-world conditions.
