• Jiangchao Long, Yong Huang, and Jun Guo.
• Intensive Care Department, People's Hospital of Dafang, Bijie, China.
• Medicine (Baltimore). 2024 Jul 26; 103 (30): e38967e38967.

BackgroundMillettia pachycarpa Benth, rich in rotenone, can disrupt the mitochondrial electron transport chain. Ingestion may cause respiratory and central nervous system depression, and in severe cases, lead to death. This is the first detailed clinical case report of M. pachycarpa Benth poisoning, aiming to help systematization of diagnosis and treatment.Patient ConcernsAn elderly male who lost consciousness for 3 hours after consuming the fruit of M. pachycarpa Benth. Arterial blood gas analysis indicated a significant decrease in pH, a sharp increase in lactate levels, and elevated CO2 partial pressure with normal O2 partial pressure.DiagnosisThe patient was diagnosed with food intoxication by M. pachycarpa Benth, concomitant with aspiration pneumonia and distributive shock.InterventionsThe patient was given continuous renal replacement therapy (CRRT) and invasive mechanical ventilation.OutcomesThe patient was successfully discharged after 5 days of hospitalization. Follow-up after 2 weeks showed no significant discomfort.ConclusionIsolated CO2 retention without hypoxemia, significantly reduced pH, and markedly elevated lactate levels strongly suggest poisoning by M. pachycarpa Benth. CRRT and invasive mechanical ventilation are beneficial for patients. Early implementation of CRRT to remove toxins and early initiation of assisted ventilation to improve respiratory failure are recommended upon suspicion of the disease.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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