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.
Remaley
A T
AT
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104.
Hicks
D G
DG
Kane
M D
MD
Shaw
L M
LM
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