# Human fluoroacetate poisoning: A case series of 36 patients in Vietnam

## TL;DR

A study in Vietnam reports on 36 cases of fluoroacetate poisoning, showing most patients had mild symptoms and no deaths, suggesting effective treatment.

## Contribution

This is the first systematic clinical case series of human fluoroacetate poisoning in Vietnam.

## Key findings

- Most patients (69.4%) presented early and were asymptomatic despite confirmed exposure.
- No deaths occurred among 36 patients, contrasting with historically high fatality rates.

## Abstract

Fluoroacetate poisoning is a rare but potentially lethal condition. We retrospectively reviewed 36 consecutive patients (27 males and 9 females) with confirmed poisoning treated at the Poison Control Center, Bach Mai Hospital, Hanoi, Vietnam, from June 2023 to December 2024. The mean age was 35.4 ± 12.6 years. The median time from ingestion to hospital admission was 3.5 h. On admission, 69.4 % of patients were asymptomatic, 22.2 % had seizures, and 8.3 % presented with altered consciousness. The mean Glasgow Coma Scale (GCS) score was 13.9 ± 2.0 (range 5–15). Median serum creatinine and creatine kinase (CK) levels were 72 µmol/L and 155 U/L, respectively; 16.7 % of patients had CK > 1000 U/L. Median ionized calcium was 1.015 mmol/L, and 19.4 % had serum lactate ≥ 2 mmol/L. Gastric lavage and activated charcoal were administered in 44.4 % and 36.1 % of cases, respectively. Six patients (16.7 %) required intensive care unit (ICU) admission, and no deaths occurred. Overall, most patients presented early with mild manifestations and had favorable short-term outcomes under supportive management.

•This is the first systematic clinical case series of human fluoroacetate poisoning in Vietnam.•Most patients (69.4 %) presented early and were asymptomatic despite confirmed exposure.•No deaths occurred among 36 patients, contrasting with historically high fatality rates.•A minority developed significant abnormalities, including CK > 1000 U/L in 16.7 % of cases.•Lower GCS scores on admission were more common among patients requiring ICU care.•Early recognition and supportive management were associated with favorable short-term outcomes.

This is the first systematic clinical case series of human fluoroacetate poisoning in Vietnam.

Most patients (69.4 %) presented early and were asymptomatic despite confirmed exposure.

No deaths occurred among 36 patients, contrasting with historically high fatality rates.

A minority developed significant abnormalities, including CK > 1000 U/L in 16.7 % of cases.

Lower GCS scores on admission were more common among patients requiring ICU care.

Early recognition and supportive management were associated with favorable short-term outcomes.