Agricultural Pesticide Injection into the Rectus Abdominis Muscle: A Case Report

Abstract

Many reports have described cases where pesticides were drunk, inhaled, or applied to body surfaces with the intent to commit suicide, but incidents of direct intramuscular pesticide injection are rare. Cyantraniliprole is a pesticide that causes disorganized muscle contraction, paralysis, and death in insects. Herein, we report a case in which a man injected cyantraniliprole into his abdomen but recovered well. An 80-year-old man visited the emergency room with abdominal pain after intramuscularly injecting 3 mL of cyantraniliprole into his abdomen. The injection site showed cellulitis with local redness, edema, and pain. Diffuse fluid collection over the right rectus abdominis muscle and subcutaneous layer was observed on abdominal computed tomography. There were no other systemic symptoms such as dyspnea or general weakness. After the abdominal inflammation improved, the tissue where the pesticide had penetrated was excised and delayed primary closure was performed. Six months after surgery, the patient had recovered well without any other local complications or systemic symptoms. Based on the outcome of the patient’s hospital course, the lethality of intramuscular injection of cyantraniliprole appears to be low.