Hydrogen cyanamide poisoning; rare but serious, case report

Abstract: Background: Pesticides are used widely and are one of the major causes of intentional poisoning. Hydrogen cyanamide is highly toxic; causing massive vomiting, hypotension, shock and drowsiness. Case report: Adult male patient in the third decade was admitted to Cairo university toxicology center in January 2015 with suicidal ingestion of unknown amount of known hormonal plant regulator called DORMEX (active ingredient is hydrogen cyanamide). The patient experienced sever vomiting and diarrhea. He was tachypnic, with low blood pressure and his pupils were bilaterally constricted. ABG shows metabolic acidosis with normal other routine labs. Sodium bicarbonate was given till ABG improved. Later, the patient was shocked, Dopamine and noradrenaline were started, and then he was stabilized. Then after 5 hours patient was arrested, CPR was started, but, the patient died. Conclusion: This case may be, in our national toxicology center, the first reporting poisoning case with ingestion of hydrogen cyanamide with a suicidal intent. The case was rapidly deteriorated in spite of good supportive treatment, ended by death due to shock and refractory metabolic acidosis.