Dhooria Sahajal, Behera Digambar, Agarwal Ritesh
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
BMJ Case Rep. 2015 Oct 1;2015:bcr2015210296. doi: 10.1136/bcr-2015-210296.
Amitraz is used as an ectoparasiticide for dogs and cattle. Human poisoning due to amitraz may be misdiagnosed as organophosphate/carbamate (OPC) toxicity, since amitraz poisoning shares several clinical features (miosis, bradycardia and hypotension) encountered with OPC poisoning. A 19-year-old man with an alleged history of suicidal ingestion of a pesticide presented with drowsiness and was found to have constricted pupils, hypotension and bradycardia. He was diagnosed as a case of OPC poisoning and was treated with atropine and pralidoxime prior to presentation to our centre. Absence of a hypersecretory state, and the presence of hyperglycaemia and hypothermia along with a normal serum cholinesterase level suggested an alternate possibility. Retrieval of the poison container confirmed the diagnosis of amitraz poisoning. The patient made a rapid recovery with supportive management. Clinician awareness is key to successful management of this poisoning, which carries a good prognosis.
双甲脒用作犬类和牛的体外寄生虫杀虫剂。由于双甲脒中毒与有机磷酸酯/氨基甲酸酯（OPC）中毒有一些共同的临床特征（瞳孔缩小、心动过缓和低血压），因此双甲脒导致的人体中毒可能会被误诊为OPC中毒。一名据称有自杀性摄入农药病史的19岁男子出现嗜睡症状，被发现有瞳孔缩小、低血压和心动过缓。在转诊到我们中心之前，他被诊断为OPC中毒病例，并接受了阿托品和氯解磷定治疗。无分泌亢进状态、存在高血糖和体温过低以及血清胆碱酯酶水平正常提示了另一种可能性。找回毒物容器证实了双甲脒中毒的诊断。患者通过支持性治疗迅速康复。临床医生的认识是成功处理这种中毒的关键，这种中毒预后良好。
