polyserositis: an unusual complication of aluminum phosphide poisoning

background: aluminum phosphide is the common cause of poisoning in adults in india, with a very high case fatality ratio. we studied five patients of aluminum phosphide poisoning with polyserositis. methods: we enrolled all patients with aluminum phosphide poisoning presenting to emergency medical department, at a tertiary care hospital in northwestern india from january to july 2006. these patients were managed according to a standard treatment protocol and their complications were recorded. results: during the study period, total of 35 patients were admitted with 57.5% mortality in the first 12 hours. among the rest, 5 patients were found to develop polyserositis. all these patients had severe hypotension at presentation and developed respiratory distress requiring mechanical ventilation after an average stay of 3.8 days post-ingestion. they were managed conservatively and four of them were discharged from the hospital after the average stay of 10 days. conclusion: in this case series, features of polyserositis (pleural effusion, ascites and pericardial effusion) were found in 15% patients of severe aluminum phosphide poisoning. we postulate systemic capillary leak syndrome, secondary to mitochondrial damage in the endothelium, as a possible mechanism.