Journal of Clinical and Experimental Investigations

Abstract

Objectives: Thallium is one of the most suitable agents for criminal poisoning of human as it is tasteless and odorless. The aim of this study was to report clinical features of thallium poisoning in two outbreaks.
Materials and methods: This case descriptive study was conducted in Basrah Teaching Hospital from January 2009 to February 2010, where a total of 32 patients with thallium poisoning were enrolled. At the first outbreak, poisoning occurred due to ingestion of cake, while the second outbreak was due to acci-dental ingestion of rat poisons. A detailed history was taken and complete clinical examination was per-formed. Thallium in urine was measured using the colorimetric method and was found as positive in all patients.
Results: Thirty two patients were evaluated. The first outbreak included 17 patients (mean age 24 years), and the second outbreak included 15 patients (mean age15 years). Among both outbreaks the derma-tological findings were mainly hair loss in diffuse and patchy pattern affected the scalp and limbs. Also dusky ecchymotic red dermatitis like rash was observed on the face, especially perioral region and dor-sum of hands and legs. Neurologic manifestations, mainly of peripheral neuropathy, were seen in 50% patients of the second group. Patients erroneously had received zinc-sulphate before correct diagnosis. Thirty patients were improved and two died.
Conclusion: Outbreak of thallium poisoning may be result of accidental ingestion or criminal purposes. It gives characteristic cutaneous, neurological and psychological features that can lead to the definite diag-nosis.