Veterinary and human toxicology
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We present the case of a patient who attempted suicide by ingestion of the rodenticide zinc phosphide. Zinc phosphide manifests its immediate toxicity through production of phosphine gas. ⋯ Delayed deaths are related to a direct cardiotoxicity. Treatment is mainly symptomatic and supportive; aggressive airway management and circulatory support are critical to a successful outcome.
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Methemoglobinemia following fire exposure is largely unrecognized. Fire related morbidity and mortality are customarily attributed to thermal injury, associated trauma, and carbon monoxide poisoning. ⋯ Relatively low levels of methemoglobin could complicate concomitant carbon monoxide poisoning by additive or synergistic effects on oxygen binding and delivery. We report 3 cases of significant methemoglobinemia (levels of 19, 12, and 12%) in survivors of a dwelling fire and review the literature with regard to this phenomenon.