Treatment and Symptoms of Cypermethrin Exposure
Cypermethrin exposure primarily causes neurotoxic, gastrointestinal, and dermal effects that should be treated with supportive care, decontamination, and symptomatic management. 1, 2
Symptoms of Cypermethrin Exposure
Dermal Exposure
- Paraesthesia (abnormal skin sensations) is the most common effect of skin exposure, particularly affecting the face 1
- Symptoms are exacerbated by sensory stimulation such as heat, sunlight, scratching, sweating, or water application 1
- Skin irritation, burning sensation, and itching may occur at the site of contact 1
Ingestion
- Sore throat, nausea, vomiting, and abdominal pain occur within minutes of ingestion 1
- Mouth ulceration, increased secretions, and dysphagia (difficulty swallowing) may develop 1
- Systemic effects appear 4-48 hours after exposure 1
Neurological Symptoms
- Dizziness, headache, and fatigue are common symptoms 1
- Palpitations, chest tightness, and blurred vision occur less frequently 1
- Severe poisoning can lead to coma and convulsions, which are the principal life-threatening features 1, 3
Cardiovascular Effects
- Prolonged bradycardia (abnormally slow heart rate) has been reported in some cases 2
- In severe cases, an organophosphate-like toxidrome may develop, creating diagnostic confusion 3
Treatment Approach
Immediate Management
- Remove the patient from exposure and perform thorough decontamination 1, 3
- For skin exposure, wash the affected area thoroughly with soap and water 3
- For ingestion, perform gastric lavage if the patient presents within 1 hour of ingestion 3
Supportive Care
- Maintain airway, breathing, and circulation 3
- Mechanical ventilation may be required in severe cases with respiratory depression 3
- Monitor vital signs, particularly heart rate and respiratory function 2, 3
Symptomatic Treatment
- For bradycardia, low-dose atropine sulfate may be administered 2, 3
- For paraesthesia, topical application of dl-alpha tocopherol acetate (vitamin E) may reduce severity 1
- Anticonvulsants for seizure control if needed 1
- Most patients recover within 6 days with appropriate supportive care 1
Important Considerations
- Avoid high-dose atropine treatment (commonly used for organophosphate poisoning) as it may cause complications in cypermethrin poisoning 3
- Distinguish from organophosphate poisoning, as the clinical presentation can be similar but management differs 3
- No specific antidote exists for cypermethrin poisoning; treatment is primarily supportive 1, 3
Prevention of Exposure
- Use protective clothing (long-sleeved shirts, long pants) when handling cypermethrin 4
- Apply DEET-containing repellents to exposed skin and clothing 4
- Permethrin (a related compound) can be used on clothing but should not be applied directly to skin 4
- Frequently inspect skin and clothes when working in areas where exposure is possible 4
- Wash skin treated with repellents with soap and water after returning indoors 4