SIR GANGA RAM HOSPITAL PEDIATRICIAN DR ANIL SACHDEV SAVES CRITICAL LIFE OF 14 YEAR OLD BOY WHO INGESTED MOSQUITO REPELLENT

A 14 year old boy from North Delhi after having tiff with parents decided to end his life by drinking a refill of mosquito repellent kept in his room . Never did he imagine that to save him doctors will have to struggle for more than 60 hours in the ICU and that  his unique survival case study will be published in  Journal of Clinical Toxicology .

After ingestion , the color of his body changed into blue and his panicked parents rushed him to a private hospital in Delhi . Inspite of hospital’s best efforts , the child’s condition was deteriorating . He was referred  to  Department of Pediatrics , Sir Ganga Ram Hospital on 01^st November 2014 in a critical condition .

According to Dr Anil Sachdev , Director , Pediatric Emergency , Critical Care and Pulmonolgy , Sir Ganga Ram Hospital , “When we received the child in our casualty , he was in a critical shape . His hemoglobin was at dangerously low levels of 3.6 (normal 13+) . The liver was affected with jaundice and kidneys were at high risk of failure . The  methemoglobin levels were rising which meant that oxygen supply to vital organs was getting reduced  . There was very high risk of irreversible damage to his organs . “

The child was  immediately shifted to the Pediatric ICU . Latest protocols were tried to resuscitate  and to increase the urine output , so that his kidneys could be salvaged . Inspite of repeated dosage of methyline blue and high dosage of Vitamin –C , his methemoglobin levels were rising dangerously . His further tests revealed that he was suffering from G6PD deficiency therefore the treatment protocol needed to be changed  .

 “At this stage , it was decided to perform urgent plasma exchange . This  is a procedure involving the separation and removal of the plasma from the blood in order to remove a disease substance circulating in the plasma. The red blood cells, white blood cells, and platelets are returned to the patient, along with a prescribed replacement fluid.” said Dr Sachdev .

Dr Sachdev further added , “Even though , evidence for plasma exchange in literature is limited to case reports , we decided to give this therapy to our patient in view of G6PD deficiency . As per our knowledge , no case was reported  till date to have these complications after transfluthrin ingestion .”

Transfluthrin is a synthetic pyrethroid derivative used as an insecticide . Kerosene is the solvent used in the preparation of liquid mosquito repellent vaporizer . There is no specific antidote for transfluthrin toxicity .

After Plasma Exchange , the patient started improving and was shifted to ward after 60 hours of struggle in ICU . He was discharged from hospital in stable condition after 6 days of stay in the hospital .

This case highlights that accidental or intentional ingestion of liquid mosquito repellent can lead to life threatening complications .