Carbamate poisoning in early childhood and in adults.
OBJECTIVE
Retrospective evaluation of the clinical course of carbamate poisoning in young children and adults.


METHODS
Thirty-six children aged 1 to 8 years (median 2.5 years) and 24 adults aged 17 to 41 years (median 22 years) ingested rat poison resulting in carbamate poisoning. The ingested poisons in all cases were positively identified as methomyl or aldicarb by gas chromatography-mass spectrometry.


RESULTS
Symptoms of intoxication in children were compared to those in adults with similar depression of the serum cholinesterase. The predominant symptoms in young children were central nervous system depression and hypotonia. The most common muscarinic effect was diarrhea. In adults, the main signs were miosis and fasciculations. Fasciculations in children were less frequent. Central nervous system depression, hypotonia, and diarrhea were uncommon in adults.


CONCLUSIONS
Based on a relatively large number of carbamate poisonings in young children, we conclude that the clinical presentation differs from adult poisoning manifestations. The absence of classic muscarinic effects does not exclude the possibility of carbamate poisoning in young children with central nervous system depression.
Lifshitz
M
M
Toxicology Unit, Soroka Medical Center, Beer-Sheva, Israel.
Shahak
E
E
Bolotin
A
A
Sofer
S
S
D000293:Adolescent; D000328:Adult; D000448:Aldicarb / Q000506:poisoning*; D002490:Central Nervous System / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D002802:Cholinesterases / Q000097:blood; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000506:poisoning*; D008724:Methomyl / Q000506:poisoning*; D018721:Muscarinic Agonists; D011041:Poisoning / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012378:Rodenticides / Q000506:poisoning; D013405:Suicide; D013564:Sympathetic Nervous System / Q000187:drug effects
D007306:Insecticides; D018721:Muscarinic Agonists; D012378:Rodenticides; D008724:Methomyl; D000448:Aldicarb; D002802:Cholinesterases