Case Report

Autor: F Uys, M O’Neill, Z Farina, J Belford
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: South African Medical Journal, Vol 113, Iss 2 (2023)
Druh dokumentu: article
ISSN: 0256-9574
2078-5135
DOI: 10.7196/SAMJ.2023.v113i2.16832
Popis: The illegal practice of combining organophosphates (OPs) with other compounds such as carbamates and pyrethroids, creating ‘streetpesticides’, is common in South Africa. These agents contain mostly unknown quantities of unregulated toxins and contribute to atypicaland unpredictable clinical presentations following human ingestion. We present such a case in a patient with intentional rodenticideingestion. The initial presentation in the emergency department was a classic cholinergic toxidrome, and clinical resolution was achievedafter provision of atropine. This was followed 12 hours later by an acute decompensation resulting from an apparent sympatheticallydriven episode of autonomic instability and acute pulmonary oedema requiring immediate respiratory and haemodynamic support. In ourdiscussion, we explore this secondary decompensation and suggest various pathophysiological explanations for this atypical clinical coursefollowing what had appeared to be OP poisoning. The patient was discharged home after a total of 6 days in hospital.
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