1. Kaulgud RS, HB N, Kurjogi MM, S V, Vanti GL. Serum
Organophosphorus compound levels as a surrogate
marker for severity assessment and management in
Acute Organophosphorus Poisoning - A novelapproach. J
PharmBiomed Anal. 2024;247:116237. doi:10.1016/j.
jpba.2024.116237
2. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The
global distribution of fatal pesticide self-poisoning:
systematic review. BMC Public Health. 2007 Dec 21;7:357.
doi:10.1186/1471-2458-7-357
3. Kır MZ, Öztürk G, Gürler M, Karaarslan B, Erden G, Karapirli M,
et al. Pesticide poisoning cases in Ankara and near by cities in
Turkey: an 11-year retrospective analysis. J Forensic Leg Med.
2013;20(4):274-277. doi:10.1016/j.jflm.2012.10.003
4. Yousef A, Albuali W, AlOmari M, El Mutayri A, Albuali WH, Al
Qurashi OF, et al. Organophosphate Poisoning in a Paediatric
Intensive Care Unit: A Retrospective Analysis Based on Ten
Years of Experience. Int J Gen Med. 2022;15:6269-6277.
Published 2022 Jul 21. doi:10.2147/IJGM.S373707
5. Sarıtaş A, Çakır Z, Aslan S, Organophosphate and Carbamate
Toxicity, EAJM: 39, April 2007
6. Seltzer JA, Friedland S, Friedman NA, Winkler AG, Foreman
E, Mubarak AY, et al. Accidental organophosphate poisoning:
A case series of 2 pediatric coumaphos exposures. J Am Coll
Emerg Physicians Open. 2022;3(6):e12859. Published 2022
Dec 1. doi:10.1002/emp2.12859
7. Bouchard MF, Bellinger DC, Wright RO, Weisskopf MG.
Attention-deficit/hyperactivity disorder and urinary
metabolites of organophosphate pesticides. Pediatrics.
2010;125(6):e1270-e1277. doi:10.1542/peds.2009-3058
8. Bouchard MF, Chevrier J, Harley KG, Kogut G, Vedar M,
Calderon N, et. al. Prenatal exposure to organophosphate
pesticides and IQ in 7-year-old children. Environ Health
Perspect. 2011;119(8):1189-1195. doi:10.1289/ehp.1003185
9. Chhabra J, Oberoi A, Pandita N, Banga V. The Enigma of
Delayed Neurotoxicity in Organophosphate Poisoning:
A Case Report of Clinical Presentation With Normal MRI
Findings. Cureus. 2024;16(6):e62877. Published 2024 Jun 21.
doi:10.7759/cureus.62877
10. Acar D, Tekin FC. The problem of unconscious and
unidentified patients in emergency department admissions;
a 3-year retrospective study. PLoS One. 2024;19(7):e0307540.
Published 2024 Jul 24. doi:10.1371/journal.pone.0307540
FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT
Introduction: Organophosphates are used as pesticides in agriculture and poisoning is widespread all over the world. Organophosphates inhibit the enzyme cholinesterase which breaks down acetylcholine in the nervous system. As a result of this inhibition, acetylcholine accumulates in the central nervous system, autonomic ganglia and nerves. This leads to cholinergic discharge. The clinical picture depends on cholinergic discharge and varies from nonspecific symptoms to coma. Mortality and morbidity are high.
Case report: A 3.5-year-old male patient was brought to the emergency department unconscious. On initial evaluation, he had a Glasgow coma scale of 10 and concomitant myosis and bradycardia. Haemogram, blood electrolytes, blood glucose, brain tomography and electrocardiogram were normal. In his medical history, it was learnt that he had contact with organophosphate inhalation. Procedure and treatment were planned.
Conclusion: The diagnosis of organophosphate poisoning is based on medical history and clinical findings and there is no specific laboratory test. Therefore, it is vital to make a differential diagnosis in patients presenting with coma and confusion. In our patient, the diagnosis of organophosphate poisoning was understood after a detailed medical history and we would like to emphasise the importance of medical history in the differential diagnosis.
This study was designed as a case report and written informed consent was obtained from the patient's parents. It will be sent to you by e-mail.
Destekleyen Kurum
No funding support was received for this study.
Teşekkür
We thank the patient's parents for their consent
Kaynakça
1. Kaulgud RS, HB N, Kurjogi MM, S V, Vanti GL. Serum
Organophosphorus compound levels as a surrogate
marker for severity assessment and management in
Acute Organophosphorus Poisoning - A novelapproach. J
PharmBiomed Anal. 2024;247:116237. doi:10.1016/j.
jpba.2024.116237
2. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The
global distribution of fatal pesticide self-poisoning:
systematic review. BMC Public Health. 2007 Dec 21;7:357.
doi:10.1186/1471-2458-7-357
3. Kır MZ, Öztürk G, Gürler M, Karaarslan B, Erden G, Karapirli M,
et al. Pesticide poisoning cases in Ankara and near by cities in
Turkey: an 11-year retrospective analysis. J Forensic Leg Med.
2013;20(4):274-277. doi:10.1016/j.jflm.2012.10.003
4. Yousef A, Albuali W, AlOmari M, El Mutayri A, Albuali WH, Al
Qurashi OF, et al. Organophosphate Poisoning in a Paediatric
Intensive Care Unit: A Retrospective Analysis Based on Ten
Years of Experience. Int J Gen Med. 2022;15:6269-6277.
Published 2022 Jul 21. doi:10.2147/IJGM.S373707
5. Sarıtaş A, Çakır Z, Aslan S, Organophosphate and Carbamate
Toxicity, EAJM: 39, April 2007
6. Seltzer JA, Friedland S, Friedman NA, Winkler AG, Foreman
E, Mubarak AY, et al. Accidental organophosphate poisoning:
A case series of 2 pediatric coumaphos exposures. J Am Coll
Emerg Physicians Open. 2022;3(6):e12859. Published 2022
Dec 1. doi:10.1002/emp2.12859
7. Bouchard MF, Bellinger DC, Wright RO, Weisskopf MG.
Attention-deficit/hyperactivity disorder and urinary
metabolites of organophosphate pesticides. Pediatrics.
2010;125(6):e1270-e1277. doi:10.1542/peds.2009-3058
8. Bouchard MF, Chevrier J, Harley KG, Kogut G, Vedar M,
Calderon N, et. al. Prenatal exposure to organophosphate
pesticides and IQ in 7-year-old children. Environ Health
Perspect. 2011;119(8):1189-1195. doi:10.1289/ehp.1003185
9. Chhabra J, Oberoi A, Pandita N, Banga V. The Enigma of
Delayed Neurotoxicity in Organophosphate Poisoning:
A Case Report of Clinical Presentation With Normal MRI
Findings. Cureus. 2024;16(6):e62877. Published 2024 Jun 21.
doi:10.7759/cureus.62877
10. Acar D, Tekin FC. The problem of unconscious and
unidentified patients in emergency department admissions;
a 3-year retrospective study. PLoS One. 2024;19(7):e0307540.
Published 2024 Jul 24. doi:10.1371/journal.pone.0307540
Kuzucu, S. (2024). FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT. Journal of Emergency Medicine Case Reports, 15(4), 87-89. https://doi.org/10.33706/jemcr.1531621
AMA
Kuzucu S. FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT. Journal of Emergency Medicine Case Reports. Aralık 2024;15(4):87-89. doi:10.33706/jemcr.1531621
Chicago
Kuzucu, Selin. “FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT”. Journal of Emergency Medicine Case Reports 15, sy. 4 (Aralık 2024): 87-89. https://doi.org/10.33706/jemcr.1531621.
EndNote
Kuzucu S (01 Aralık 2024) FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT. Journal of Emergency Medicine Case Reports 15 4 87–89.
IEEE
S. Kuzucu, “FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT”, Journal of Emergency Medicine Case Reports, c. 15, sy. 4, ss. 87–89, 2024, doi: 10.33706/jemcr.1531621.
ISNAD
Kuzucu, Selin. “FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT”. Journal of Emergency Medicine Case Reports 15/4 (Aralık 2024), 87-89. https://doi.org/10.33706/jemcr.1531621.
JAMA
Kuzucu S. FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT. Journal of Emergency Medicine Case Reports. 2024;15:87–89.
MLA
Kuzucu, Selin. “FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT”. Journal of Emergency Medicine Case Reports, c. 15, sy. 4, 2024, ss. 87-89, doi:10.33706/jemcr.1531621.
Vancouver
Kuzucu S. FROM SYMPTOM TO DIAGNOSIS: A CASE OF ORGANOPHOSPHATE POISONING IN AN UNCONSCIOUS PAEDIATRIC PATIENT. Journal of Emergency Medicine Case Reports. 2024;15(4):87-9.