Poisoning: Aluminium phosphide (celphos)

Introduction

• It is  a solid  fumigant  insectiside,  pesticide  and  rodenticide.  Aluminium  phosphide  on coming  in  contact  with  moisture, liberates  phosphine.
• 3  gm  of  aluminium phosphide liberates  1 gm  of  phosphine.
• Phosphine  acts  by  inhibiting electron  transport  system  mainly cytochrome  oxidase.
• Gastric  acid  enhances  its  toxicity.

Clinical  features:

• Garlic odour  and  blood  stained  froth  at mouth,  nostril and  stomach.
• Congestion,  edema,  sloughing,  necrosis  and leucocytic  infiltration  of  mucosa (of  GIT especially  lower  esophagus, stomach,  duodenum),  lungs,  kidney,  adrenals,  liver,  spleen  and  brain
• Myocardial  necrosis
• Esophageal  strictures  and fistula  occur  in few survivors.
• There may be  circulatory  collapse with  metabolic  acidosis.
• Cardiogenic  shock  is  the  most common  cause of death.
• Gastric  lavage  fluid  gives  black  colour  in  presence  of silver  nitrate, because  of reaction  of phosphine  with silver nitrate.
• Aluminium  phosphite  and  hypophosphite  are  nontoxic  salts

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