Unintentional fatal phosphine gas poisoning of a family.

OBJECTIVE: The objective of the study was to report the toxicity of phosphine gas after a residential fumigation that resulted in fatal poisoning of a 15-month-old toddler and her 4-year-old sibling. METHODS: This is a case report and a review of literature. RESULTS: A family of 6 members was exposed to phosphine gas after their yard was treated with aluminum phosphide for a rodent infestation. The inhalation of phosphine gas initially caused symptoms of abdominal distress in all of the family members. Within 36 hours of exposure, the 4-year-old sibling died of cardiopulmonary failure in a local emergency department. After an initial presentation of respiratory distress, the 15-month-old toddler progressed to complete cardiopulmonary collapse and did not survive despite aggressive intervention including extracorporeal membrane life support. CONCLUSIONS: Unintentional phosphine gas exposure is rare but has a toxic profile that results in a high fatality rate with no known antidote.