{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:17:22Z","timestamp":1780345042688,"version":"3.54.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Aluminum phosphide is a commonly used pesticide, particularly in developing countries where uncontrolled insecticides and pesticides are commonly prevalent. Mortalities have been reported due to accidental and suicidal exposures to aluminum phosphide. To date, there has been no reported mortality case of aluminum phosphide in Lebanon. In addition, there is no specific antidote for aluminum phosphide toxicity and the treatment is mainly supportive. This is why awareness should be spread about this case to include it in the differential diagnoses and enhance prompt management and response in future encounters.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A previously healthy 37-year-old male, presented to the emergency department\u00a0of\u00a0Notre Dame des Secours University Hospital Center for a suicidal attempt after ingesting 5 tablets of pesticide containing 56% aluminum phosphide an hour prior to presentation. Shortly after the presentation, the patient began deteriorating and became clinically unstable. The patient was then intubated and was started on sodium bicarbonate along with aggressive fluid resuscitation. The patient remained hypotensive even after giving vasopressors. He was then later admitted to the intensive care unit for further management. However, the patient further decompensated and developed multiorgan failure. This is the first case of mortality in Lebanon from aluminum phosphide toxicity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Emergency physicians should include aluminum phosphide toxicity in the differential diagnosis when dealing with patients ingesting unknown pesticides especially when they smell the characteristic garlic-like odor. The toxicity from ALP leads to multiorgan failure and death rapidly. Thus, it is of utmost importance to start early, and aggressive resuscitation given that there is no specific antidote.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12245-024-00591-8","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T15:03:13Z","timestamp":1707231793000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The first reported mortality from aluminum phosphide poisoning in Lebanon: a case report"],"prefix":"10.1186","volume":"17","author":[{"given":"Pierre","family":"Edde","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony El","family":"Kortbawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeina","family":"Halabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Sakr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alondra","family":"Barakat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tharwat El","family":"Zahran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"issue":"6","key":"591_CR1","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1002\/jat.1692","volume":"31","author":"R Anand","year":"2011","unstructured":"Anand R, Binukumar B, Gill KD. Aluminum phosphide poisoning: an unsolved riddle. J Appl Toxicol. 2011;31(6):499\u2013505.","journal-title":"J Appl Toxicol"},{"issue":"1\u20133","key":"591_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.forsciint.2011.06.018","volume":"214","author":"GS Bumbrah","year":"2012","unstructured":"Bumbrah GS, Krishan K, Kanchan T, Sharma M, Sodhi GS. Phosphide poisoning: a review of literature. Forensic Sci Int. 2012;214(1\u20133):1\u20136.","journal-title":"Forensic Sci Int"},{"issue":"3\u20134","key":"591_CR3","first-page":"66","volume":"66","author":"K Soltaninejad","year":"2012","unstructured":"Soltaninejad K, Nelson LS, Bahreini SA, Shadnia S. Fatal aluminum phosphide poisoning in Tehran-Iran from 2007 to 2010. 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J Anal Toxicol. 2000;24(2):90\u20132.","journal-title":"J Anal Toxicol"},{"issue":"2","key":"591_CR6","doi-asserted-by":"publisher","first-page":"e33016","DOI":"10.32598\/ijmtfm.v11i2.33016","volume":"11","author":"M Shakeri","year":"2021","unstructured":"Shakeri M, Soroosh D, Shakeri H, Kalani N, Hatami N, Foroughian M. Successful treatment of acute aluminum phosphide poisoning by aloe vera syrup: a case report. Int J Med Toxicol Forensic Med. 2021;11(2):e33016.","journal-title":"Int J Med Toxicol Forensic Med"},{"issue":"4","key":"591_CR7","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1191\/0960327105ht513oa","volume":"24","author":"S Shadnia","year":"2005","unstructured":"Shadnia S, Rahimi M, Pajoumand A, Rasouli M-H, Abdollahi M. Successful treatment of acute aluminium phosphide poisoning: possible benefit of coconut oil. Hum Exp Toxicol. 2005;24(4):215\u20138.","journal-title":"Hum Exp Toxicol"},{"key":"591_CR8","doi-asserted-by":"publisher","first-page":"102868","DOI":"10.1016\/j.amsu.2021.102868","volume":"70","author":"S Katwal","year":"2021","unstructured":"Katwal S, Malbul K, Mandal SK, Soniya K, Alam MZ, Karki P, et al. Successfully managed aluminum phosphide poisoning: a case report. Ann Med Surg. 2021;70:102868.","journal-title":"Ann Med Surg"},{"issue":"12","key":"591_CR9","doi-asserted-by":"publisher","first-page":"735","DOI":"10.4103\/0972-5229.171412","volume":"19","author":"U Baruah","year":"2015","unstructured":"Baruah U, Sahni A, Sachdeva HC. Successful management of aluminium phosphide poisoning using intravenous lipid emulsion: report of two cases. 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Indian J Anaesth. 2010;54(4):302.","journal-title":"Indian J Anaesth"}],"container-title":["International Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-024-00591-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12245-024-00591-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-024-00591-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T15:03:19Z","timestamp":1707231799000},"score":1,"resource":{"primary":{"URL":"https:\/\/intjem.biomedcentral.com\/articles\/10.1186\/s12245-024-00591-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,6]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["591"],"URL":"https:\/\/doi.org\/10.1186\/s12245-024-00591-8","relation":{},"ISSN":["1865-1380"],"issn-type":[{"value":"1865-1380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,6]]},"assertion":[{"value":"9 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"In this single case report, the need for formal ethics approval and written informed consent was considered by the Institutional Review Board (IRB) of the American University of Beirut (AUB). Given the unique and isolated nature of this case, the IRB has determined that formal ethics approval is not required and written informed consent from the patient, or their legal representatives is not applicable. The IRB acknowledges that this case report does not involve any identifiable or sensitive patient information, and its publication serves the purpose of contributing to medical knowledge and awareness. Therefore, the requirement for formal ethics approval and written informed consent has been waived by the IRB.The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The case report involves a patient who has regrettably passed away. Despite our diligent efforts to contact the patient\u2019s family, including the next of kin and legal guardian, we have been unable to establish any communication with them. This lack of response has made it exceedingly challenging to secure their informed consent for the publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18"}}