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Suicide after inhaling a pyrethrins containing insecticide spray
  1. L R van den Bersselaar1,
  2. J G van der Hoeven1 and
  3. B de Jong2
  1. 1 Department of Intensive Care Medicine, Radboudumc, Nijmegen, The Netherlands
  2. 2 Department of Intensive Care Medicine, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
  1. Correspondence to drs. L R van den Bersselaar, luuk.vandenbersselaar{at}


Pesticide self-poisoning is rare in developed countries. We report a suicide case after inhalation of a pyrethrins containing insecticide spray. The patient presented at the emergency department with respiratory failure. Despite mechanical ventilation, he developed severe pulmonary inflammation with a systemic inflammatory response syndrome and died 5 days later. Studies reporting on acute pyrethrins or pyrethroids insecticide poisoning in both occupational and non-occupational cases usually describe mild and self-limiting respiratory symptoms as the predominant symptom. Severe or fatal cases of pyrethrins or pyrethroids poisoning are very rare. Patients with asthma or allergies are apparently more at risk for severe symptoms. In these cases, early and aggressive treatment with bronchodilatators, steroids, antihistamines and epinephrine should be considered.

  • adult intensive care
  • poisoning
  • respiratory medicine

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  • Contributors All authors were involved in the clinical care for the patient. All authors contributed to writing this manuscript. The first version of this manuscript was written by LRvdB. JGvdH and BdJ reviewed this manuscript several times. All authors approved the final version of the manuscript. All authors agree to be all accountable for aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.