A 50-year-old man was admitted to the emergency department with abrupt massive 
epistaxis. An accurate anamnesis and physical evaluation could not reveal any 
other anomalies, while coagulation tests showed potentially life threatening 
prolonged prothrombin time, with activated partial thromboplastin and thrombin 
time, with fibrinogen and antithrombin III within limits. Despite the prompt 
pharmacological and compressive local treatment, bleeding continued and the 
patient was therefore hospitalized. Highly specific coagulation and 
toxicological testing-among others high-performance liquid chromatography 
assessment on plasma-were performed, leading to the unexpected identification of 
brodifacoum. Police and criminal justice authorities revealed the source of 
exposure to brodifacoum after several months of investigation, residing in his 
everyday life. Brodifacoum is a long-lasting anticoagulant, acting as a vitamin 
K antagonist, and belongs to the family of superwarfarins. Brodifacoum use is 
authorized as rodenticide in many countries worldwide, but has been reported as 
cause of severe coagulopathies in humans, both intentional or involuntary, even 
consumed as a contaminant of herbal drugs, such as cannabis. The original 
contribution of this case to the knowledges of human brodifacoum intoxication 
resides in the multidisciplinary approach and the collaborative interplay of 
clinical and toxicology experts as well as judicial authorities.