Severe organophosphate (demeton-S-methyl) poisoning in a two-year-old child.
A previously healthy 2-y-old boy was admitted to the hospital 30 min after the ingestion of 10 ml of demeton-S-methyl (META-SYSTOX). Treatment consisted of gastric decontamination, atropine, reactivator (obidoxime) and supportive therapy. Atropine was given to control the muscarinic features. Assisted ventilation was required for 6 h; however, this treatment was able to be discontinued following the second injection of obidoxime 11.5 h after the ingestion. Excess salivation and slight bradycardia were easily controlled with small doses of atropine for 5 d following admission to Ullevaal Hospital. Further course was uneventful, and the patient was discharged on the 8th d without any sequelae. Plasma cholinesterase levels were initially low (<400 U/l), but returned to reference values upon discharge. In this case, adequate supportive therapy and the rapid administration of both atropine and obidoxime were clearly associated with a favorable outcomes
Department of Pediatrics, Hedmark Central Hospital, Elverum, Norway.
L B
LB
Rolfsjord
H O
HO
Fjaerli
N
N
Meidel
J H
JH
Stromme
M
M
Kowalczyk
D
D
Jacobsen
D000931:Antidotes / Q000494:pharmacology; D001285:Atropine / Q000627:therapeutic use; D002675:Child, Preschool; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009768:Obidoxime Chloride / Q000627:therapeutic use; D062025:Organophosphate Poisoning; D063086:Organothiophosphates; D011041:Poisoning / Q000188:drug therapy
D000931:Antidotes; D002801:Cholinesterase Reactivators; D007306:Insecticides; D018727:Muscarinic Antagonists; D063086:Organothiophosphates; D009768:Obidoxime Chloride; D001285:Atropine; C030064:demeton-S-methyl