Acute chlordane intoxication.

This report describes a patient who accidentally ingested 215 g of chlordane in a liquid pesticide formulation. The patient experienced multiple acute clinical sequellae attributable to his acute intoxication, including vomiting, diarrhea, seizures, coma and respiratory failure. Upon initial presentation and during the recovery phase, blood and urine specimens were collected to measure the disposition and elimination of chlordane and its metabolites. Whole blood chlordane concentrations measured over the subsequent 49 days suggested a multicompartmental kinetic profile of chlordane distribution, with an approximate terminal elimination half-life of 34 days. Tissue samples obtained from this patient, during elective surgery 58 days post chlordane ingestion, revealed persistent high levels of chlordane related metabolites. This case illustrates the physiological distribution and elimination of chlordane and its related metabolite residues after acute intoxication in an adult patient. Such information is important to improve the clinical management of patients acutely exposed to potentially lethal levels of pesticides.