Brain damage caused by chlorfenapyr poisoning: a case report and literature review

Chlorfenapyr poisoning is uncommon, but fatal, and is often ignored. Chlorfenapyr inhibits ATP production in the mitochondrial of lipid-rich organs such as the brain. The initial symptoms of chlorfenapyr poisoning are not serious and are usually ignored; fever and unconsciousness are the main signs. Patients often die of brain damage, and survivors often present toxic leukoencephalopathy. We report a case of a 15-year-old female who swallowed 10 mL of 10% chlorfenapyr, and was subjected to gastric lavage one hour after ingestion. The patient felt no discomfort on the first and second day after lavage and went to school. On the third day, the patient complained of a headache and rested at home. On the fourth day, the patient still complained of headache, and the condition progressed to confusion and fever; therefore, the patient was admitted to the emergency room and underwent hemoperfusion. Cerebral CT revealed diffuse brain edema. The patient died on the fourth day because of central fever, brain hernia, and brain dysfunction. Chlorfenapyr poisoning is fatal, even in small doses. Patients suspected of chlorfenapyr poisoning should be closely observed and promptly treated by hemoperfusion.