Acute aldicarb (Chumbinho) poisoning in a young Brazilian woman: A case report

Abstract

Chumbinho, the colloquial name for aldicarb, is a highly toxic carbamate insecticide illicitly sold in Brazil. Carbamates are potent inhibitors of the enzyme acetylcholinesterase, leading to a characteristic cholinergic toxidrome (muscarinic syndrome, nicotinic syndrome, and central nervous system acetylcholine accumulation). This case report describes a young Brazilian woman who presented to the emergency department in a coma with symptoms suggestive of cholinergic syndrome. Toxicological analysis revealed aldicarb metabolites. The patient was treated with atropine, resulting in the resolution of acute intoxication. Despite the WHO's 1991 ban on carbamates, systematic reviews indicate that acute intoxications and associated mortality rates remain high. Effective dissemination of information and education strategies are essential to prevent the use of these unauthorized products. Emergency physicians must develop expertise in toxicology to promptly recognize and treat these intoxications.

Keywords

• aldicarb
• atropine
• cholinergic toxidrome
• chumbinho
• poisoning