an interesting case of aluminum phosphide poisoning

Ingestion and inhalation of phosphine are 2 forms of toxicity and their clinicalmanifestation is extremely wide. a 22-year-old girl was admitted with complaints ofnausea, vomiting and epigastric pain after eating lunch. she had a history of celiacdisease. on arrival, she was alert and hemodynamically stable. there was not anyabdominal tenderness or guarding. food poisoning treatment initiated but after 1 hourher condition deteriorated with hypotension, tachycardia, and epigastric pain. venousblood gas (vbg) showed severe metabolic acidosis. she denied any drug ingestionagain. new electrocardiogram (ecg) showed extensive inferolateral st elevationmyocardial infarction (stemi). bicarbonate plus dopamine was initiated. after 8hours of admission, rhythm became ventricular fibrillation (vf) and cardiopulmonaryresuscitation (cpr) began. peritoneal dialysis was performed. next morning frequentvf occurred again but cpr was unsuccessful. family found aluminum phosphide (aip)tablets in her purse. early diagnosis and supportive treatment may be effective but themost important factor is the dose of ingestion.