Baygon-Induced Pulmonary Edema

Our plain-English summary of Baygon-Induced Pulmonary Edema, by G. Salisbury, C.F. Tate JR, J.E. Davies (1974).

The study

• Authors: G. Salisbury, C.F. Tate JR, J.E. Davies
• Published: Chest Volume 65 No.6 April 1974
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article is a case report about poisoning with propoxur (Baygon), a carbamate household insecticide. It does not concern asbestos. The authors described what they called the only reported case of propoxur-induced pulmonary edema (fluid in the lungs). A 30-year-old black woman was brought to the emergency room in a coma on Nov. 3, 1971. She had pinpoint pupils that did not react to light, and crackling sounds in both lungs. Baygon and its breakdown product, 2-isopropoxyphenol, were found in her stomach contents. Her urine was negative for the breakdown product on admission. She received supportive care, including a breathing tube, frequent suctioning and oxygen. A chest X-ray about 18 hours after admission showed marked improvement, and the breathing tube was removed after 24 hours. On waking, she said she had swallowed an unknown insecticide in a suicide attempt. The authors concluded that a cuffed breathing tube and mechanical ventilation are especially important in this poisoning. They also concluded that blood cholinesterase tests, which were normal in her, are not reliable indicators of propoxur exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 30-year-old black woman brought to the emergency room in a coma on Nov. 3, 1971 (authors at the University of Miami School of Medicine, Jackson Memorial Hospital, Miami). The age is as printed in the case report; the age in the article's own abstract is illegible.
• Exposure: Swallowed propoxur (Baygon), a common household insecticide of the carbamate family that blocks the enzyme cholinesterase. The patient later said she had swallowed an unknown insecticide in a suicide attempt.
• Main results:
  • On arrival, both of the patient's pupils were pinpoint and did not respond to light.
  • Testing of the patient's stomach contents found Baygon and its main breakdown product, 2-isopropoxyphenol.
  • The patient's urine was negative for the breakdown product on admission.
  • Atropine given intravenously over 10 minutes produced no response in the patient, although her pulse rate rose from 120 to 140 per minute.
  • The patient's treatment was supportive, including a breathing tube, vigorous and frequent suctioning, and oxygen.
  • A repeat chest X-ray of the patient, taken about 18 hours after admission, showed marked resolution of the pulmonary edema.
  • The patient was weaned off the breathing tube and extubated after 24 hours.
  • The patient's red blood cell and plasma cholinesterase levels were normal despite documented propoxur exposure. The authors stated that these tests are not reliable indicators of propoxur presence or toxicity.
  • On the cause of the pulmonary edema, the authors stated that a direct toxic effect on the lung capillaries could not be ruled out. They suggested that aspiration of bronchial secretions should be considered.
• The authors' conclusion: The authors concluded that a cuffed endotracheal (breathing) tube and mechanical ventilation are especially important in propoxur-induced pulmonary edema, because of heavy airway secretions needing frequent suctioning and the danger of respiratory failure.

Topics

Medical terms in this study, explained in our Lexicon: Chest X-Ray.

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