Semptomdan Tanıya Organofosfat İntoksikasyonu

Öz

Zehirlenme olguları acil servislerde sıkça karşılaşılan önemli bir sağlık sorunudur. Zehirlenmelere akut süreçte müdahalede gecikme artmış mortalite ve morbiditeye neden olabilir. Organik fosfor bileşikleri tüm dünyada yaygın olarak tarımda, evlerde, bahçelerde, veterinerlikte ve kimyasal silah yapımında kullanılmaktadır. Yılda yaklaşık 3 milyon insan organofosfatlara maruz kalmakta ve 300 bine yakını ölmektedir. Olgumuzda daha önce bilinen hastalığı olmayan jeneralize tonik klonik nöbet geçirme sonrası acile başvuran 13 yaşında kız hasta sunulmuştur. Hastanın zehirlenme öyküsü olmamasına rağmen klinik ve laboratuvar bulgularının organofosfat intoksikasyonu özellikleri taşıması nedeniyle verilen atropin ve pralidoksim tedavilerine dramatik cevap alınmıştır. Hasta daha sonradan intihar amaçlı böcek ilacı içtiğini itiraf etmiştir. Acil servise başvurularda özellikle daha önceden sağlıklı çocuklarda abdominal kramplar, lakrimasyon ve salivasyon artışı, solunum sıkıntısı, aritmi, anksiyete, nöbet, bilinç bulanıklığı görülmesi durumunda organofosfat zehirlenmeleri akla gelmelidir.

Anahtar Kelimeler

• Kolinerjik semptomlar, Nöbet, Organofosfat zehirlenmesi

Organophosphate Poisoning from Symptoms to Diagnosis

Öz

Poisoning is an important health problem that is common in emergency services. Delay in intervention in the acute process of poisoning can lead to increased mortality and morbidity. Organic phosphorus compounds are widely used in agriculture, in houses, in gardens, in veterinary medicine and in chemical weapons production all around the world. Approximately 3 million people are exposed to organophosphates per year and nearly 300 thousand die. We present a 13-year-old previously healthy girl with generalized tonic clonic seizures. Although there was no pertinent poisoning history, the diagnosis was made based on the clinical signs and the dramatic response to atropine and pralidoxime treatments. After the resolution of the symptoms, the patient confessed that she had attempted suicide with an insecticide. Emergency organophosphate intoxication should be considered especially if abdominal cramps, increased lacrimation and salivation, respiratory distress, arrhythmia, anxiety, seizure, and decreased consciousness are observed in previously healthy children

Anahtar Kelimeler

• Cholinergic symptoms, Seizure, Organophosphate poisoning

Kaynakça

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