Hemoptysis after exposure to a household insecticide spray: A case report and review of the literature

We describe a case of chemical pneumonitis with alveolar hemorrhage after acute exposure to a common household pyrethrin spray in a patient on anticoagulation with underlying chronic obstructive pulmonary disease (COPD). We review the relevant literature pertaining to adverse respiratory effects of pyrethrin based insecticide spray exposures. This case report highlights the importance of including potential inhaled household respiratory irritants in the differential for patients that present to the emergency department (ED) in respiratory distress. While aerosolized pyrethroid and pyrethrin containing domestic products generally do not cause significant respiratory symptoms when accidentally inhaled, the risk of serious adverse events may be increased in those patients with preexisting respiratory disease or who have used the product within a confined space. Timely recognition of adverse respiratory events related to pyrethroid or pyrethrin inhalation, airway protection and supportive care are the pillars of treatment for these patients.