Acute arsenic suicidal poisoning – a rare case

Arsenic is a naturally occurring element in the earth's crust. Chronic arsenic poisoning has been regularly reported predominantly due to occupational exposure in the literature. Acute arsenic poisoning is very rare. A 27-year-old gentleman was brought to the hospital with a history of suicide attempt by consumption of arsenic trioxide diluted in water. He initially manifested with gastrointestinal manifestations along with tachycardia. The patient was treated with fluid resuscitation, antidote-Dimercaprol, dialysis, and other supportive treatment. The patient continued to deteriorate with deranged liver and renal function, coagulopathy, and neurological symptoms. The presence of coagulopathy further complicated the scenario, as the antidote which is administered as an intramuscular injection could not be given. The patient continued to deteriorate and eventually succumbed. Acute arsenic poisoning is very rare, and very few reports of suicide are reported. It initially presents with acute gastroenteritis symptoms followed by multi organ involvement. Fatal doses will invariably result in death irrespective of treatment modality. Rapid administration of antidote and supportive treatment might increase the chances of survival. Difficulty in the availability of oral antidote and unavailability of any Intravenous preparations further complicates the scenario.