Laboratory assessment of poisoning with a carbamate insecticide.
We discuss a case of a 17-year-old white male who intentionally ingested a tick and flea insecticide and was admitted to the emergency room unconscious, with signs and symptoms of cholinergic toxicity. Capillary gas chromatography and electron-impact mass fragmentographic analysis of the patient's urine and serum demonstrated the presence of poly-ethylene glycol and propoxur (o-isopropoxyphenyl N-methyl-carbamate), a carbamate-based cholinesterase inhibitor commonly used in insecticides. The patient fully recovered, but only after a complicated hospital course. We also discuss the laboratory assessment and clinical treatment of poisoning with carbamate and organophosphate insecticides.
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104.
A T
AT
Remaley
D G
DG
Hicks
M D
MD
Kane
L M
LM
Shaw
D000293:Adolescent; D002091:Butyrylcholinesterase / Q000378:metabolism; D002493:Central Nervous System Diseases / Q000139:chemically induced / Q000503:physiopathology; D055598:Chemical Phenomena; D002621:Chemistry; D002800:Cholinesterase Inhibitors; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007306:Insecticides / Q000032:analysis / Q000506:poisoning*; D008297:Male; D013058:Mass Spectrometry; D011092:Polyethylene Glycols / Q000097:blood / Q000652:urine; D001074:Propoxur / Q000097:blood / Q000652:urine
D002800:Cholinesterase Inhibitors; D007306:Insecticides; D011092:Polyethylene Glycols; D001074:Propoxur; D002091:Butyrylcholinesterase