Pandit Vinay, Seshadri Shubha, Rao S N, Samarasinghe Charmaine, Kumar Ashwini, Valsalan Rohith
Department of Medicine, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
J Emerg Trauma Shock. 2011 Jan;4(1):132-4. doi: 10.4103/0974-2700.76825.
Organophosphate (OP) poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis.
有机磷中毒在印度很常见。关于胃肠外有机磷中毒的病例报告仅有少数。我们报告一例自行注射甲基对硫磷中毒的病例，患者在四天后出现癫痫发作、意识改变和呼吸窘迫，这带来了诊断和治疗上的困境。尽管无法获得有机磷中毒的病史，但基于怀疑对其进行了治疗，并且对阿托品和氯解磷定的治疗试验显示出良好的临床反应，患者成功康复。胃肠外给予有机磷毒物后可能会出现非典型表现，即使对此稍有怀疑也需要进行适当的检查和治疗以获得良好预后。持续低血浆胆碱酯酶水平是进行诊断的有用标志物。
