Zinc phosphide is a rodenticide that causes poisoning by reacting with stomach acid to form phosphine gas, a toxic protoplasmic poison. Symptoms include vomiting, breathing difficulties, circulatory collapse, coma and death within 24 hours due to respiratory or hepatic failure. Treatment involves gastric lavage, activated charcoal, antacids and correcting metabolic acidosis. Zinc phosphide poisoning is often used for suicide or homicide and can cause fatty liver changes, jaundice and renal failure upon autopsy. Chronic zinc oxide vapor inhalation in industrial settings causes metal fume fever with influenza-like symptoms.