Acetonitrile ingestion: delayed onset of cyanide poisoning due to concurrent ingestion of acetone

Abstract

A fatal case of acetonitrile ingestion is reported. The patient presented having apparently taken an overdose but was well until around 24 hours after the supposed ingestion, when cardiovascular collapse and profound metabolic acidosis developed. Later investigation revealed that the patient had taken acetone and acetonitrile. Acetone is known to slow the metabolism of acetonitrile to cyanide, thereby delaying the appearance of toxicity.