Aluminium phosphide is commonly used in agricultural areas in Tunisia to protect wheat grains from pests. It is an extremely toxic rodenticide associated with very high mortality. It inhibits mitochondrial cytochrome oxidase and causes cell hypoxia. Here we are presenting a fatal case of aluminium phosphide poisoning with an electrocardiographic pattern of Brugada syndrome.

A 14-year-old girl with no past medical history presented to the emergency department with severe abdominal pain and vomiting. She ingested a quarter tablet of aluminium phosphide after a conflict with a classmate. She was rapidly admitted in the intensive care unit (ICU). Because of low blood pressure, patient received intensive fluid resuscitation and norepinephrine. Patient developed refractory shock, severe rhythm disturbances and metabolic acidosis. The main Electrocardiogram (ECG) finding is a type 1 Brugada syndrome pattern. She died despite aggressive resuscitation in the ICU after 7hours from ingestion.

Aluminium phosphide is an extremely dangerous rodenticide. It induces vasoplegic shock with severe metabolic acidosis. A rare cardiac arrythmia with a Brugada pattern is described and discussed in this observation. Management is mainly symptomatic. Legislative control is a key element of the prevention of this intoxication.