Shah_2024_JNMA.J.Nepal.Med.Assoc_62_702

Cartap, a nereistoxin derivative from the marine annelid Lumbriconeresis heteropoda, is widely used as a pesticide, targeting pests like caterpillars. While the WHO classifies it as moderately hazardous, with a recommended daily intake of 0.05 mg/kg, human toxicity reports are limited. A 34-year-old female was admitted after consuming an unknown poison. She reported epigastric pain, burning sensations, sweating, vomiting, dyspnea, palpitations, and restlessness, compounded by alcohol intake. Initially treated for organophosphate poisoning, her cholinesterase level was 8.91. It was later confirmed she ingested 100 ml of 50% concentration cartap. Treatment included amiodarone for supraventricular tachycardia and intravenous N-acetylcysteine, magnesium sulfate, and midazolam for general tonic clonic seizure. Cartap, toxic through ingestion and skin contact, can cause symptoms such as vomiting, convulsions, and cardiac issues like supraventricular tachycardia. Supportive care is crucial, and awareness of its risks is necessary.