Case History

 

An Agromedicine Program Consulting Physician (APCP) conferred with Dr. Schuman regarding a 30-year-old farmer who became ill while spraying a cotton field. The farmer had been spraying PIX® (mepiquat chloride), a bioregulator that improves yield, and Baythroid® (cyfluthrin), a synthetic pyrethroid insecticide.

 

While spraying the chemicals, a light breeze caused the spray to drift back onto the farmer and his spray rig.  The farmer became nauseated and vomited shortly after inhaling the spray. His lips swelled. He also became dizzy and was disoriented. He was able to return to his home where his wife immediately telephoned the physician for assistance.

 

The farmer’s symptoms were consistent with an acute anaphylactoid reaction to the synthetic pyrethroid insecticide. Pyrethroids are synthetic analogues to pyrethrins, which are the active ingredients of pyrethrum derived from the chrysanthemum. “Hypersensitivity reactions (to pyrethrins) are not rare. Symptoms range from allergic rhinitis, conjunctivitis, and dermatitis to anaphylactic shock requiring emergency treatment.”1

 

In addition to giving the APCP a toll free telephone number for the medical consultant of the insecticide’s producer, Dr. Schuman recommended antihistamines and steroids. Referral to an allergist was also advised.

 

1Schuman SH and Simpson WM. AG-MED: The rural practitioner’s guide to agromedicine, diagnosis and management at a glance. American Academy of Family Physicians, 1997.

 

DEPARTMENT OF FAMILY MEDICINE – DIVISION OF PUBLIC HEALTH AND PUBLIC SERVICE

MEDICAL UNIVERSITY OF SOUTH CAROLINA, 171 ASHLEY AVENUE, CHARLESTON, SC 29425-2217