A case report of severe organophosphate poisoning and aspiration pneumonitis treated with exchange blood transfusion.

Background Organophosphate poisoning causes a significant disease burden in low- and middle-income countries and places a huge demand on critical care facilities. Case report We present the case of a 5-year-old with severe organophosphate poisoning from ingestion of chlorpyrifos, further worsened by aspiration of a charcoal-palm oil mixture. The clinical illness was marked by respiratory failure, shock, coma and type I paralysis. The patient was treated in the emergency department with noninvasive ventilation, multiple episodes of exchange transfusion, intravenous atropine, inotrope infusion, antibiotics and steroids. The patient responded rapidly to treatment, did not develop intermediate syndrome and was discharged after 10 days of admission. Conclusion The dearth of paediatric intensive care facilities and complex medical equipment in many low- and middle-income countries necessitates the use of other treatment modalities for critical conditions. This case report highlights the relevance of exchange transfusion in detoxification of severe organophosphate poisoning in children.