pralidoxime and Coma

Topics: Adult; Antidotes; Atropine; Cardiotonic Agents; Cholinesterase Reactivators; Cholinesterases; Coma; Dopamine; Humans; Insecticides; Male; Muscarinic Antagonists; Pralidoxime Compounds; Suicide, Attempted; Toluidines

An outbreak of food poisoning that affected at least ten people in various regions of Japan was traced to exposure to Chinese dumplings contaminated with the organophosphate insecticide Methamidophos. We experienced the most serious case, a five years old girl, who suffered coma. She presented with features of cholinergic overactivity and her serum cholinesterase activity was 9 U/l. We started intravenous treatment with pralidoxime iodide, atropine sulfate, and midazolam. Her symptoms improved gradually and she was discharged on day 25 without any sequelae. Though poisoning attributed to organophosphate insecticides has become less common in recent years, it is even more important to diagnose the problem rapidly based on the characteristic symptoms and to start specific treatment at the earliest possible stage after poisoning.

Topics: Atropine; Child, Preschool; China; Coma; Female; Foodborne Diseases; Humans; Insecticides; Japan; Midazolam; Organothiophosphorus Compounds; Pralidoxime Compounds

After cutaneous application of the organophosphate insecticide Diazinon for pubic lice, our patient had symptoms of cholinergic excess, lost consciousness, and had a seizure. Because of the high index of clinical suspicion for potentially lethal organophosphate poisoning, the patient received empiric therapy with pralidoxime and atropine and completely recovered.

Topics: Atropine; Coma; Diazinon; Humans; Insecticides; Lice Infestations; Male; Middle Aged; Pralidoxime Compounds; Seizures; Self Medication; Skin Absorption