Accidental Ingestion of Vacor Rodenticide: The Symptoms and Sequelae in a 25-Month-Old Child

A recently introduced rodenticide containing N-3-pyridylmethyl N′-p-nitrophenyl urea (PNU), Vacor, was accidently ingested by a 25-month-old child, resulting in acute vomiting, lethargy, seizures, and hypoglycemia, as well as chronic evidence of autonomic and peripheral neuropathy and glucose intolerance. Treatment with niacinamide (nicotinamide), may have been of benefit since all problems were resolved within three months of ingestion. This agent (PNU) is remarkably similar chemically and toxicologically to alloxan and streptozocin, both potent beta-cell toxins. These similarities are not only important in regard to the antidote for PNU, but they also suggest that the toxin may cause long-term endocrinologic, neurologic, and oncologic problems. (Am J Dis Child 134:161-164, 1980.