Fatal Imidacloprid Poisoning in Humans

Neonicotinoids, agonists at the nicotinic acetylcholine receptors (nAChRs), induce neuromuscular paralysis. The high selectivity for nAChRs (particularly the a4b2 subtype) in insects compared with mammals results in their favorable toxicological profile. We describe fatal toxicity with one such insecticide, imidacloprid, considered relatively safe. This patient manifested neurological dysfunction and rhabdomyolysis. The initial neurological dysfunction, probably due to central nicotinic stimulation, was compounded by ischemic and metabolic encephalopathy. This report of imidacloprid toxicity sensitizes clinicians to an emerging cause of poisoning and highlights the need for a careful review of its toxicity profile.

Source: Ramya Iyyadurai & Ige Abraham George & John Victor Peter. J. Med. Toxicol. (2010) 6:77–78