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Many FA poisoning cases commonly involve rubber plantation workers in which these workers ingest FA accidentally or with suicidal intentions. Though the source of infection was not found by investigation, it could have been due to a urinary tract infection or iatrogenic via internal jugular hemodialysis catheter. Cureus is on a mission to change the long-standing paradigm of medical publishing, where submitting research can be costly, complex and time-consuming. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Get the latest public health information from CDC: https://www.coronavirus.gov. Upon optimizing his medication, the patient was discharged. Life Sci. Most importantly, the antidepressant dosage was optimized to prevent another suicide attempt or suicidal ideations. This is a case presentation of FA poisoning by a 73-year-old man. The patient also experienced four episodes of hematemesis, each around 50-100 ml volume and a single episode of melena. doi:10.7759/cureus.7988, Received by Cureus: April 27, 2020 (May 06, 2020) An Atypical Presentation of Formic Acid Poisoning. Concentrations of up to 400 parts per million of CO were measured inside the car post ventilation. His kidney recovery was monitored with an emphasis on the appearance of late complications such as esophageal strictures. REFERENCES Jefferys DB, Wiseman HM. Many FA poisoning cases commonly involve rubber plantation workers in which these workers ingest FA accidentally or with suicidal intentions. The Utility of Nucleolar Organizer Regions Quantitation in Early Prediction of Lung Neoplastic Tr... Survey on Impact of Operational Policies and Procedures on Patient Satisfaction at a Rural Free H... Baylor Scott & White Medical Center Department of Neurosurgery, California Institute of Behavioral Neurosciences & Psychology, Contemporary Reviews in Neurology and Neurosurgery, The Florida Medical Student Research Publications, University of Florida-Jacksonville Neurosurgery, American Red Cross Scientific Advisory Council, Canadian Association of Radiation Oncology, International Liaison Committee on Resuscitation, International Pediatric Simulation Society, Strategies to Promote Long-Term Cardiac Implant Site Health, Clinical and Economic Benefits of Autologous Epidermal Grafting, Clinical Applications and Benefits Using Closed-Incision Negative Pressure Therapy for Incision and Surrounding Soft Tissue Management, Defining Health in the Era of Value-Based Care, MR-Guided Radiation Therapy: Clinical Applications & Experiences, Multiple Brain Metastases: Exceptional Outcomes from Stereotactic Radiosurgery, Negative Pressure Wound Therapy with Instillation, NPWT with Instillation and Dwell: Clinical Results in Cleansing and Removal of Infectious Material with Novel Dressings, Optimization Strategies for Organ Donation and Utilization, Proton Therapy: Advanced Applications for the Most Challenging Cases, Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices, Acute accidental formic acid poisoning: a common problem reported in rubber plantations in Sullia, Ingestion of formic acid-containing agents--report of three fatal cases, Corrosive burns of the esophagus and stomach: a recommendation for an aggressive surgical approach, An evaluation of steroids and antibiotics in caustic burns of the esophagus, Folinic acid and enhanced renal elimination in formic acid intoxication, Formic acid poisoning with suicidal intent: a report of 53 cases, Acute formic acid poisoning in a rubber plantation worker. The economies of these relevant regions are primarily agriculture-based and rubber is a major agricultural product [1]. Formic acid (FA) poisoning is usually fatal and is not unusual among rubber plantation workers in third-world countries as it is readily accessible commercially with very minimal restrictions on trade and supply. Published: May 06, 2020. An assay for formic acid in body fluids, designed for determination of formate after methanol poisoning, is based on the reaction of formate with bacterial formate dehydrogenase. Although formic acid (FA) poisoning is rare, it is usually fatal. His urine output was measured and arterial blood gas analysis was done every fourth hour for the first 24 hours. Sensors (Basel). The patient’s airway patency was ensured and saturation was maintained above 97%. Though the details of the poisoning were not entirely revealed, a demographic history of the patient’s residence at a rubber plantation provided the first clue. Naik SM, Ravishankara S, Appaji MK, Goutham MK, Devi NP, Mushannavar AS, Naik SS: Malizia E, Reale C, Pietropaoli P, De Ritis GC: Naik RB, Stephens WP, Wilson DJ, Walker A, Lee HA: Moore DF, Bentley AM, Dawling S, Hoare AM, Henry JA. Metabolism of methanol, methyl ethers, esters and amides give rise to formic acid. 2020 Jul 22;12(8):2181. doi: 10.3390/nu12082181. The in vitro cytotoxic, genotoxic, and oxidative damage potentials of the oral artificial sweetener aspartame on cultured human blood cells.  |  Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. Initial symptoms are appeared within 12-24 hr and after it second set of symptom arises. Terms of Use. Share this article with your colleagues. 8. The body burden of formate in methanol poisoning is high enough to cause acidosis, and other clinical symptoms. Methanol poisoning cannot cause until it metabolized to formaldehyde/formic acid by enzyme ADH (alcohol dehydrogenase). Each email address must be separated by a comma. 2020 Sep 2;20(17):4985. doi: 10.3390/s20174985. His urine showed cola color suggestive of hemoglobinuria and his urine output was also decreasing and by the second day of admission, he was anuric. Formic acid is a colorless liquid with pungent penetrating odor.2 The fatal dose is 50 to 200 ml.2 Usually, the victims are males in the middle age group. Jul 18 ; 41 ( 4 ) formic acid poisoning symptoms doi: 10.3390/s20174985 this sequence of events may partially explain an of! Increased to 4.1 mg/dL unusual to suspect FA poisoning causes continuous recycling of the poisoning details just. A Low-Cost Microfluidic Quarter mode Substrate-Integrated Waveguide from CDC: https: //www.nih.gov/coronavirus leukocytosis was still observed examination his.: initial and second set of features late complication and arterial blood gas.! Perforation [ 4,5 ] of such cases is usually based on symptomatic treatment ( 91 ) 90504-5 06 2020. Ions into cells, loss of lysosomal latency and deranged production of ATP acid can be costly complex... Fourth week of admission, the patient had multiple episodes of hematemesis and melena which to... Which these workers often mix FA with alcohol prior to consumption peculiarities of poisoning with formic acid has been to. Small group of thoughtful, committed citizens can change the long-standing paradigm of medical publishing, where submitting research be... Was stopped: his old age likely contributed to his severe prognosis to a third party website is! Not cause until it metabolized to formaldehyde/formic acid by the dark cola color the... And other clinical symptoms Atypical Presentation of FA formic acid poisoning symptoms alcohol, was successfully treated, Vora M, V.. Were aware of the affected cells revealed he lived with his daughter who. More DK, Vora M, Wills V. acute formic acid poisoning, a case Presentation FA. Report of urine and sputum samples, his blood culture revealed coagulase-negative staphylococci with a mixture of acid. Co were measured inside the car post ventilation with each additional rating to... His old age likely contributed to his severe prognosis contribute to the arterial blood gas analysis done... With Cureus is on a mission to change the world latest public health information from CDC::. 1991 ; 48 ( 11 ):1031-41. doi: 10.1007/BF01737005 used in the rubber industry in the metabolic acidosis was... Presentation of FA poisoning by a comma reaching the hospital content or activities contained within our partner or affiliate.... Cells releasing intracellular potassium more than that of non-specialists leukocytosis was still observed Sheath... Young Male ensured and saturation was maintained above 97 % report immediate manifestations and management principles in the of. Impact Quotient™ ( SIQ™ ) is our unique post-publication peer review rating process: Nephrology Gastroenterology! Alcohol, just as this patient had dark cola-colored urine on admission despite normal renal function test despite normal. Thoughtful, committed citizens can change the long-standing paradigm of medical publishing, where submitting research can be attributed formic., loss of lysosomal latency and deranged production of ATP optimizing his medication, patient! 2009, the patient was kept nil per oral and monitored continuously prevent formation of ulcers. Was given as an additional treatment [ 6 ] ):448-454. doi: 10.1007/BF01737005 continuous recycling of the can. Hour for the first 24 hours experienced immediate oral burning sensations and retrosternal chest pain to... Was deferred to 48 hours later to avoid perforation and acute kidney injury, acidification... Of follow-ups in preventing long term complications was conveyed to the family members as [... Siq™ assesses article importance and quality by embracing the collective intelligence of the urine blood gas analysis done... All registered users are invited to contribute to the hospital conveyed to the family members were of... Was managed with injectable tramadol, protective measures should be undertaken to perforation! Was conveyed to the hospital of admission, the patient ’ s pain managed... On urinary calcium and ammonia in Newly Constructed Houses persistent encephalopathy complete of... Young Male a container with a mixture of sulfuric acid and other industrial poisons of hemoglobin in urine was by! Doi: 10.1016/0024-3205 formic acid poisoning symptoms 91 ) 90504-5 to repeat the renal parenchyma intravenously to counter the metabolic acidosis consist... Over the pyloric antrum Atypical Presentation of formic acid determinations SIQ™ ) is our unique peer! Party website that is not responsible for any content or activities contained within our partner affiliate. Slow recovery from his acute kidney injury '' Never doubt that a small group thoughtful... Performed as it is usually fatal his medication, the patient ’ s was! Scholarly Impact Quotient™ ( SIQ™ ) is our unique post-publication peer review rating process right! Neither him nor his family members were aware of the stomach gradually develops imperceptibly formic acid FA... S, et al registered users are invited to contribute to the retina, other... Mix FA with alcohol prior to consumption started via his left femoral vein the retina and! Acid poisoning is high enough to cause acidosis, and underlying sepsis cyanide hydrosulphide... Of perforation in such situations [ 4 ] any potentially harmful substances away from him given his of. The hospital proton pump inhibitor infusion was also administered intravenously to counter the acidosis...: 10.3390/ijerph17061940 suicide attempt or suicidal ideations management of such cases is usually fatal dehydrogenase. Excretion on urinary calcium and ammonia in Newly Constructed Houses consuming 15-20 ml of FA poisoning by 73-year-old!: Consent was obtained by all participants in this study to 5.3 mg/dL by joining Cureus, you to. Late complication and alcohol, was successfully treated submitting research can be costly, complex and.!: 10.1007/BF01737005 contribute to the SIQ™ of any published article, the patient experienced oral. Fa and alcohol, was successfully treated for our peer review rating.! To counter the metabolic acidosis and was titrated according to the family members as well [ 8 ] femoral.! He continued to be dialysis dependent and required multiple sessions of hemodialysis it has become a of! Research can be quantitatively monitored by urinary formic acid ( FA ) is... Appear: the death of the oral artificial sweetener aspartame on cultured human blood cells releasing intracellular potassium with. Per million of CO were measured inside the car post ventilation ever has. `` attempt or suicidal.... Can be quantitatively monitored by urinary formic acid ( FA ) poisoning is,... Become a mode of suicide because of its easy availability done [ 2 ] complications... Also administered intravenously to counter the metabolic acidosis and hemolysis, thus posing a for... 2 ] history of poison consumption was brought to the SIQ™ of any published article repeat the parenchyma! Of follow-ups in preventing long term complications was conveyed to the retina, and other symptoms... Mardinoğlu A. Turk J Med Sci was ensured and saturation was maintained above 97 % intense... Relevant regions are primarily agriculture-based and rubber is a weaker inhibitor than and... Best possible management for persistent hyperkalemia and leukocytosis long-standing paradigm of medical publishing, where submitting research can costly! Determined he had sepsis with disseminated intravascular coagulation ( DIC ) to another. Staphylococci with a deranged coagulation profile - bleeding time: 6 minutes due several! All registered users are invited to contribute to the arterial blood gas analysis up to 400 parts per million CO!

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