Organophosphorus poisoning is a critical condition that can cause central nervous system depression, respiratory failure, and death early on. As its clinical manifestations closely resemble those of carbamate pesticide poisoning, the aim of this case study is to present a case of misdiagnosis, initially identifying carbofuran poisoning as organophosphate in a patient suspect of a heatstroke. We also present a case of intentional self-poisoning with organophosphate dichlorvos to underline the likelihood of pesticide poisoning in patients exhibiting acute cholinergic symptoms when the ingested substance is not known. In such cases, empirical treatment with atropine and oxime can be started pending timely differential diagnosis to adjust treatment as necessary.
Trovanje organofosfornim spojevima kritično je stanje koje rano može dovesti do depresije središnjeg živčanog sustava, zatajenja disanja i smrti. Budući da je prema kliničkoj slici blisko srodno trovanju karbamatnim pesticidima, cilj je ovoga članka prikazati slučaj pogrešne dijagnoze, koja je isprva trovanje karbofuranom identificirala kao trovanje organofosfatom u bolesnika u kojega se sumnjalo na toplinski udar. Usporedno dajemo slučaj namjernog samotrovanja organofosfatom diklorvosom da bismo naglasili koliko je velika vjerojatnost trovanja pesticidima u bolesnika s akutnim kolinergičnim simptomima kod kojih se ne zna progutana tvar. U takvim se slučajevima može započeti empirijsko liječenje atropinom i oksimom dok se ne ustanovi pravovremena diferencijalna dijagnoza i po potrebi prilagodi liječenje.
Keywords: acetilkolinesteraza; acetylcholinesterase; carbamate; carbofuran; cholinergic crisis; dichlorvos; diklorvos; intensive care; intenzivna skrb; karbamat; karbofuran; kolinergična kriza; organofosfati; organophosphates.
© 2024 Jia-ding Xia et al., published by Sciendo.