Biomedical Engineering Reference
In-Depth Information
and diuretics. Acetaminophen and cough suppres-
sants may make the patient more comfortable [5].
4.12.5 Treatment
Outer clothing should be removed and exposed skin
should be decontaminated with soap and water.
Super-activated charcoal should be given orally if
toxin is swallowed. Eye exposure should be treated
with copious saline irrigation. Supportive therapy
should be provided as needed [5].
4.12 Disease: Trichothecene
Mycotoxin (T2) Intoxication
4.12.1 Causative Agent
Trichothecene mycotoxin (T2) can theoretically
be used in aerosol to form “yellow rain” which
produces casualties. T2 can enter the body
through the skin and aero-digestive epithelium,
and quickly inhibit protein and nucleic acid
synthesis. These mycotoxins are low molecular
weight compounds produced by filamentous fungi
of the genera
Fusarium
,
Myrotecium
,
Tricho-
derma
,
Stachybotrys
and others [5].
References
1. S. S. Arnon, R. Schechter, T. V. Inglesby,
D. A. Henderson, J. G. Bartlett, M. S. Ascher,
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G. Parker, T. M. Perl, P. K. Russell,
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ical weapon: medical and public health manage-
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, 285:2081, 2001.
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(R. E. Rakel and E. T. Bope,
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Nelson Textbook of Pedi-
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, 17th Edition [Chapter 706] (R. E. Behrman,
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JAMA
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Russell, K. Tonat. Working Group on Civilian
4.12.2 Clinical Description
Time to onset of symptoms is from minutes to
hours from exposure. T2 exposure causes pruritis,
redness, vesicles, necrosis, epidermal sloughing,
dysesthesias, nausea, weight loss, vomiting, and
diarrhea. Effects on the airway include nose and
throat pain, nasal discharge, itching and sneezing,
cough, dyspnea, wheezing, chest pain, and hemop-
tysis. T2 also produces effects after ingestion or
eye contact. Severe poisoning results in prostra-
tion, weakness, ataxia, collapse, reduced cardiac
output, shock, and death [5].
4.12.3 Diagnosis
Specific identification of the various mycotoxins
is by chromatography and/or mass spectrom-
etry performed on clinical or environmental
samples [5].
4.12.4 Differential Diagnosis
Mycotoxin poisoning should be considered espe-
cially when multiple patients present with similar
clinical syndromes, particularly if victims report
a “yellow rain” or if droplets of yellow fluid
contaminate clothing or the environment. Radia-
tion, chemical, or plant toxicity are other diagnoses
to consider [5,12].
