Imidacloprid poisoning causing delayed liver Injury

Imidacloprid (IC), a widely used nicotine-containing insecticide, is primarily metabolised in the liver by the cytochrome P450 enzyme. Case reports have highlighted respiratory and central nervous system complications as the most lethal outcomes in humans. Presented here is a case involving a previously healthy 29-year-old woman who presented after ingesting an IC-containing agrochemical. On the fifth day, she developed a delayed liver injury. This case underscores the potential for delayed hepatic dysfunction following IC ingestion, despite its rarity. It is imperative to clinically review patients and repeat liver enzyme tests within the first week to promptly address delayed liver toxicity.