Analysis of Misdiagnosis and Mistreatment in 27 Patients with Anticoagulant Rodenticide Poisoning

DONG Jian-guang; ZHANG Peng; LU Xiao-xia; LONG Jian-hai; PENG Xiao-bo; WANG Chun-yan; LIU Yan-qing; BAI Li-li; WANG Hao-chun; QIU Zhe-wu

doi:10.3969/j.issn.1002-3429.2017.06.013

Abstract：Objective To analyze clinical characteristics and misdiagnosis causes of anticoagulant rodenticide poisoning in order to improve final diagnosis rate.Methods Clinical data of 27 misdiagnosed patients with anticoagulant rodenticide poisoning admitted during December 2013 and September 2016 was retrospectively analyzed.Results The misdiagnosed time was 1 day-7 months, and the average time was 24.8 days.Clinical manifestations were 23 patients with hematuria, 10 patients with gingival (oral) bleeding, 8 patients with otorrhagia or nasal bleeding, 5 patients with limb pain or activity limitation, 4 patients with vaginal bleeding or menorrhagia, 2 patients with back pain, 2 patients with abdominal pain and 1 patient with hematochezia and 1 patient with disorders of hemostasis.The misdiagnosed time was 43 times including 14 diseases, and the top four misdiagnosed diseases were as follow ureteral calculi, coagulation disorders, urinary infection and gingival bleeding.There were 21 patients with different degrees of anemia and 19 patients with coagulation disorders.There were 18 patients with brodifacoum, 18 patients with bromadiolone and 9 patients with brodifacoum and bromadiolone by blood detection.After confirming the diagnosis, the patients received treatments such as fluid replacement and decorporation, vitamin K1 supplement, plasma infusion and hemoperfusion with good prognoses.Conclusion Anticoagulant rodenticide poisoning is insidious with various clinical manifestations, and therefore clinicians should give related examinations in time in order to avoid misdiagnosis and mistreatment for highly suspected patients with anticoagulant rodenticide poisoning.