Delayed onset intermediate syndrome after organophosphate poisoning

Ahmed Hany Ayoub Mohamed I. Soliman Mohamed A. Hussein Mohammed T. Rageh

Keywords: Adult, Atropine / administration & dosage, Atropine / therapeutic use, Critical Care, Humans, Insecticides / poisoning, Intermediate syndrome, Male, Muscarinic Antagonists / administration & dosage, Muscarinic Antagonists / therapeutic use, Organophosphorus Compounds, Poisoning / diagnosis; Poisoning / drug therapy, Pralidoxime Compounds / administration & dosage, Respiration, Artificial / methods

Abstract

Intermediate syndrome is not an uncommon condition, it may occur following exposure to organophosphates, either accidental or suicidal. Picture of intermediate syndrome can develop within 24 to 96 h. We report the case of a 41-year-old male patient, who had a picture of intermediate syndrome, occurring with a delayed onset, than the usual, after exposure to an insecticide solution containing organophosphates. We stress that the patients who have recovered from initial acute cholinergic crisis, should be closely observed for the development of intermediate syndrome.

Abbreviations: ER - emergency room; GCS - Glasgow Coma Scale; ICU - intensive care unit; IMS - Intermediate syndrome

Key words: Adult; Atropine / administration & dosage; Atropine / therapeutic use; Critical Care; Humans; Insecticides / poisoning; Intermediate syndrome; Male; Muscarinic Antagonists / administration & dosage; Muscarinic Antagonists / therapeutic use; Organophosphorus Compounds; Poisoning / diagnosis; Poisoning / drug therapy; Pralidoxime Compounds / administration & dosage; Respiration, Artificial / methods

Citation: Ayoub AH, Soliman MI, Hussein MA, Rageh MT. Delayed onset intermediate syndrome after organophosphate poisoning. Anaesth. pain intensive care 2022;26(4):551-553; DOI: 10.35975/apic.v26i4.1964

Received: June 02, 2022; Reviewed: July 11,2022; Accepted: July 11,2022

Author Biographies

Ahmed Hany Ayoub

Ahmed Hany Ayoub, MD, Lecturer of Anesthesia and Intensive Care, Ain Shams university, Cairo, Egypt

Mohamed I. Soliman

Mohamed Ibrahim Soliman, MSc, EDAIC, Assistant Lecturer of Anesthesia and Intensive Care, Ain Shams university, Cairo, Egypt

Mohamed A. Hussein

Mohamed Ahmed Hussein, MSc, EDAIC, Assistant Lecturer of Anesthesia and Intensive Care, Ain Shams university, Cairo, Egypt

Mohammed T. Rageh

Mohammed Taher Rageh, MSc, EDAIC, Anesthesia and Intensive Care, Al-Azhar university, Cairo, Egypt

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