Summary
This is the first report of neuropathologic findings following oral ingestion of hexachlorophene in the human. The patient was a 7 year old boy who accidentally ingested 45 ml (approx.) of pHisoHex (hexachlorophene).Toxic reactions included nausea, vomiting, anorexia, diarrhea, decrease in visual acuity, blurred vision blindness, somnolence and disorientation. He developed cardiac arrhythmia, fever, isoelectric EEG and finally respiratory and cardiac arrest 61 h after admission.
Autopsy findings showed interstitial myocarditis, pneumonitis and acute bronchiolitis. The brain was edematous. Light microscopy revealed mild diffuse vacuolization of white matter, occasional neuronal degeneration, most prominent on deepest layers of the visual cortex. Disintegration of myelin sheaths and necrosis of axon cylinders were present throughoutoptic pathways. Electron microscopy revealed large, empty extracellular and intramyelinic spaces formed by splitting and separation of the myelin lamellae. These changes are known to occur in experimental animals intoxicated with hexachlorophene, triethyltin, isonicotinic acid hydrazide and cuprizone. However, with respect to hexachlorophene, the localization of lesions to be optic pathways appears to be dependent upon an oral route of administration.
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Martinez, A.J., Boehm, R. & Hadfield, M.G. Acute hexachlorophene encephalopathy: Clinico-neuropathological correlation. Acta Neuropathol 28, 93–103 (1974). https://doi.org/10.1007/BF00710320
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DOI: https://doi.org/10.1007/BF00710320