Analysis of Clinical Misdiagnosis of Anticoagulant Rodenticide Poisoning

XING Xuanlin; LI Yiyun; WANG Ziyu; ZHANG Linming; SONG Yugen; YOU Xinyue; XIONG Guifei; LIANG Xingling; ZHANG Qiujuan; ZHANG Bingran; LIU Mingwei

doi:10.3969/j.issn.1002-3429.2023.12.004

Abstract：Objective To explore the causes of misdiagnosis of anticoagulant rodenticide poisoning and measures to prevent misdiagnosis.Methods The clinical data of 29 patients with anticoagulant rodenticide poisoning treated from Novem-ber 2018 to September 2022 were retrospectively analyzed.Results The main clinical manifestations of the 29 patients were different degrees of skin petechial ecchymosis(n =19),gross hematuria(n =10),epistaxis(n =9),gingival bleeding(n = 7),oral mucosal bleeding(n =6)and hematochezia(n =6).They were misdiagnosed as coagulopathy 19 times,nose bleed-ing 7 times,gum bleeding 6 times,digestive tract bleeding 5 times,urinary tract infection 3 times,urinary tract calculus 3 times,hemorrhagic shock 2 times,and intestinal obstruction,drug poisoning,pleural effusion,cerebral hemorrhage,abnor-mal limb movement,and soft tissue hematoma 1 time,respectively.Misdiagnosis lasted from 1 to 60 d.After admission,ac-cording to the clinical and relevant medical technical examination,and detection of rodenticide ingredients(bromurin,brodi-olone,and difethialone),the anticoagulant rodenticide poisoning was confirmed.The coagulation function of 29 patients was improved after the first dose of intravenous infusion of vitamin K1 preparation.After 3 months to 1 year of follow-up,3 patients were lost to follow-up,and the remaining 26 patients had a good prognosis.Conclusion The history of anticoagulant rodenti-cide poisoning is not clear,and the symptoms are not specific,which,therefore,are more likely to cause miss diagnosis and misdiagnosis.In order to reduce misdiagnosis,it is necessary to be vigilant and detect serum rodenticide components in time.