Jacob Jerry, Reddy Ch Karthik, James Jobin
Department of Emergency Medicine, St John's Medical College Hospital, Bengaluru, Karnataka, India.
Indian J Crit Care Med. 2022 Jul;26(7):877-878. doi: 10.5005/jp-journals-10071-24270.
Organophosphorus (OP) pesticides are extensively used both in developed and developing countries. Organophosphorus poisoning primarily occurs through occupational, accidental, and suicidal exposures. Toxicity through parenteral injections is seldom reported and there are only very few case reports till date.
We report a case of parenteral injection of 10 mL of OP compound (Dichlorvos 76%) into a swelling over the left leg. The compound was injected by the patient himself as adjuvant therapy for swelling. Initial manifestations included vomiting, abdomen pain, and excessive secretions followed by neuromuscular weakness. The patient was subsequently intubated and treated with atropine and pralidoxime. The patient did not improve with antidotes for OP poisoning, attributed to the depot the OP compound had formed. The swelling was excised and the patient immediately showed response to the treatment. Biopsy of the swelling showed granuloma and fungal hyphae. The patient developed intermediate syndrome during the ICU stay and was discharged after 20 days of hospital stay.
Jacob J, Reddy CHK, James J. "The Toxic Depot": Parenteral Insecticide Injection. Indian J Crit Care Med 2022;26(7):877-878.
有机磷农药在发达国家和发展中国家均被广泛使用。有机磷中毒主要通过职业暴露、意外接触和自杀性接触发生。经胃肠外注射导致中毒的情况鲜有报道，迄今为止仅有极少数病例报告。
我们报告一例患者将10毫升有机磷化合物（76%敌敌畏）注射到左腿肿胀处的病例。该化合物由患者本人注射，作为肿胀的辅助治疗。初始表现包括呕吐、腹痛和分泌物过多，随后出现神经肌肉无力。患者随后接受插管，并使用阿托品和氯解磷定进行治疗。由于有机磷化合物形成了储存库，患者使用有机磷中毒解毒剂后病情并未改善。切除肿胀部位后，患者立即对治疗产生反应。肿胀部位活检显示有肉芽肿和真菌菌丝。患者在重症监护病房住院期间出现中间综合征，住院20天后出院。
雅各布·J、雷迪·CHK、詹姆斯·J。“有毒储存库”：胃肠外注射杀虫剂。《印度重症监护医学杂志》2022年；26(7):877 - 878。
