Lessenger J E, Estock M D, Younglove T
Statewide Air Pollution Research Center, University of California, Riverside, USA.
J Am Board Fam Pract. 1995 Jul-Aug;8(4):278-82.
The diagnosis of mild to moderate pesticide exposure presents a challenge because the signs and symptoms of exposure are similar to those of many other diseases. We reviewed all alleged pesticide injuries seen in a single office during a 6-year period to determine which findings were useful in discriminating between a pesticide-related illness and other causes.
We reviewed retrospectively the charts of 190 patients alleging pesticide illness who were treated in a standardized manner.
One hundred sixteen (116) patients (61.1 percent) were found to have pesticide illness. Important predictors of pesticide illness were anxiety, vertigo, nausea, vomiting, tearing, and weakness. Seventy-four patients (38.9 percent) were found to have nonpesticide-related illness, with nonspecific irritant contact dermatitis and scabies the most common diagnoses. Rash was the only significant predictor of nonpesticide related illness.
It is difficult to relate signs and symptoms to pesticide poisoning, and exposure history is very important. Alternative diagnoses need to be considered. Laboratory tests are not nearly as valuable as many might expect, and skin rash is not a common finding in mild to moderate pesticide poisoning.
轻度至中度农药暴露的诊断颇具挑战，因为暴露的体征和症状与许多其他疾病相似。我们回顾了在6年期间于单一科室就诊的所有疑似农药中毒病例，以确定哪些检查结果有助于区分农药相关疾病和其他病因。
我们回顾性分析了190例以标准化方式治疗的疑似农药中毒患者的病历。
116例（61.1%）患者被确诊为农药中毒。农药中毒的重要预测指标包括焦虑、眩晕、恶心、呕吐、流泪和乏力。74例（38.9%）患者被诊断为非农药相关疾病，最常见的诊断为非特异性刺激性接触性皮炎和疥疮。皮疹是唯一与非农药相关疾病显著相关的预测指标。
将体征和症状与农药中毒相关联存在困难，暴露史非常重要。需要考虑其他诊断。实验室检查远不如许多人预期的那样有价值，皮疹在轻度至中度农药中毒中并非常见表现。
