A young man ingests a rodenticide and presents with emesis, acute liver failure, and radiopaque debris seen on an abdominal radiograph shown. He progresses to develop cardiac arrest. What is a potential causative agent explaining the presentation?
Zinc phosphide. While rarely used as a rodenticide in the US due to its toxicity and delayed mechanism of action, multiorgan systemic toxicity occurs when phosphine gas (PH3, not to be confused with warfare agents phosgene and phosgene oxime) forms after the salt is exposed to stomach acids.
Contributed by: Joseph Kennedy, UVM Toxicology