Acute Severe Suicidal Poisoning by Celphos Powder A Rare Case Report from Rural India

Acute Aluminum Phosphide (ALP) or Celphos poisoning is extremely lethal and invariably suicidal in nature. Unfortunately it's high toxicity and absence of a specific antidote results in very high mortality. The key to treatment lies in rapid decontamination and early institution of resuscitative measures. It is a major cause of morbidity and mortality in northwest and central India. The outcome is poor, largely due to delay in appropriate management and skepticism amongst clinicians regarding the outcome. Things are further complicated by limited resources in tier 3 cities and villages where most of the cases present initially. ALP is commonly available and ingested in the form of Tablets/pellets of known amount and composition which renders a fair idea about the ingested dose of the poison. Surprisingly, in our case the victim ingested a massive dose of ALP powder to commit suicide. He could survive just because of instant and excessive vomiting, and meticulous management without any delay. Such an incidence with powder form of ALP is extremely rare and has not been reported so far, to the best of our knowledge.