Superwarfarin Rodenticide Poisoning due to Consumption of Exotic Animals: A Case Report.

Poisoning from superwarfarin rodenticides should be considered in patients with unexplained bleeding due to vitamin K deficiency, with no other history of coagulopathy or anticoagulant use. A 37-year-old man originally presented to our hospital with two weeks of oral bleeding and two days of hematuria of unknown etiology. Workup showed severely prolonged prothrombin time and extremely low activity of coagulation factors II, VII, IX, and X, raising suspicion for vitamin K deficiency. His coagulation studies gradually corrected after daily administration of high-dose intravenous vitamin K. An anticoagulant poisoning panel ultimately revealed high levels of brodifacoum rodenticide-likely from rodent meat ingestion during his vacation to China 2 months before. Our case highlights the importance of a thorough social and toxicologic investigation in patients with unexplained coagulopathy consistent with significant vitamin K deficiency.