Near fatal anticholinergic intoxication after routine fundoscopy.
We describe a case of severe anticholinergic intoxication following the topical instillation of tropicamide-containing eyedrops. Tropicamide is a short-acting atropine-like derivative and has been regarded as an effective and safe mydriatic. Half an hour after routine fundoscopy, a 62-year-old man experienced two generalized seizures with respiratory arrest and required intubation and mechanical ventilation. The patient was treated with physostigmine and made a full recovery.
Department of Internal Medicine, Karl Franzens University Graz, Austria.
G A
GA
Brunner
S
S
Fleck
T R
TR
Pieber
A
A
Lueger
P
P
Kaufmann
K H
KH
Smolle
H
H
Brussee
G J
GJ
Krejs
D000931:Antidotes / Q000627:therapeutic use; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000506:poisoning*; D009184:Mydriatics / Q000506:poisoning*; D009883:Ophthalmic Solutions; D009887:Ophthalmoscopy; D010830:Physostigmine / Q000627:therapeutic use; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000628:therapy; D012640:Seizures / Q000139:chemically induced* / Q000628:therapy; D014331:Tropicamide / Q000506:poisoning*
D000931:Antidotes; D018727:Muscarinic Antagonists; D009184:Mydriatics; D009883:Ophthalmic Solutions; D010830:Physostigmine; D014331:Tropicamide