Delayed neurotoxicity produced by an organophosphorus compound (Sumithion). A case report.
A case of late-onset manifestation of organophosphorous insecticide poisoning is described. The patient was a 70-year-old female who ingested 40 ml Sumithion emulsion (50% fenitrothion). At first, no toxic symptoms were apparent. However, 48 h after ingestion certain signs became apparent. An impediment in consciousness was observed. Fasciculation and muscular weakness were noted, while plasma and urinary 4-nitro-3-methylphenol (NMC), the degradation product of Sumithion, reached a maximum. Neither atropine sulfate nor PAM (pyridine 2-aldoxime methiodine) were effective. For 3 weeks the patient required ventilatory support, and consequently her muscle strength and neurological status gradually recovered with falling NMC levels.
D000368:Aged; D002802:Cholinesterases / Q000097:blood; D003408:Cresols / Q000097:blood / Q000652:urine; D005260:Female; D005278:Fenitrothion / Q000378:metabolism / Q000506:poisoning*; D006801:Humans; D009461:Neurologic Manifestations; D013997:Time Factors
D003408:Cresols; C008636:4-nitro-3-cresol; D002802:Cholinesterases; D005278:Fenitrothion