Document Type : Case reports


1 Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran

2 Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran


Introduction: Rodenticides are considered a global challenge to public health. Two major compounds in this category include
aluminum phosphide and zinc phosphide. However, the simultaneous use of aluminum phosphide and zinc phosphide has not
been reported in the literature.
Case Presentation: We present the case of a 20-year-old female, who was poisoned with both a rice tablet and powdered rat poison.
She was admitted to a university- affiliated hospital, Babol, Iran in July 2016. Resuscitative and supportive measures were applied,
including prophylactic intubation, gastric lavage with a bicarbonate solution, and intravenous administration of N-acetylcysteine
(NAC), magnesium sulfate, calcium gluconate, and bicarbonate compounds. In case of a blood sugar level above 100 mg/dL, regular
insulin was infused. After the diagnosis of phosphine-induced cardiomyopathy, digitization with digoxin was prescribed for the
Conclusions: This case report presents the possible positive effects of digoxin, insulin, and antioxidant therapy on simultaneous
poisoning with aluminum phosphide and zinc phosphide.