A Case of Severely Impaired Consciousness and Convulsions From Attempted Suicide by Ingesting Triflumizole Emulsion: Clinical Features and Literature Review

Abstract

Triflumizole (TFZ) is a fungicide widely used in agriculture to prevent fungal infections of fruits and vegetables. Although it is considered safe for humans and animals, its toxicity profile in humans remains largely unexplored. Here, we describe a case where an individual experienced symptoms suggestive of intoxication after ingesting TFZ emulsion. A 70-year-old man ingested TFZ emulsion (Trifumin emulsion^TM) and alcohol in an attempt to commit suicide. He developed a severe disturbance of consciousness, which was not explained by the estimated blood alcohol concentration, and experienced convulsions. We managed this patient with symptomatic treatment, temporary mechanical ventilation, and antiepileptic drugs. He subsequently recovered without any sequelae. We present the first case of acute oral intoxication with TFZ emulsion. Moreover, we review the literature on TFZ-induced organ dysfunction and discuss the possible mechanisms and management of this condition.

Keywords: agricultural fungicide; convulsion; impaired consciousness; intoxication; triflumizole.

Figure 1. Continuous electroencephalogram monitoring revealed an alpha wave pattern.