title: Systemic organophosphate poisoning following the percutaneous injection of insecticide. Case report.
abstract: Organophosphates are the most common group of chemicals in the southern part of Turkey. Although organophosphate poisoning (OPP) may occur due to skin exposure or inhalation, severe poisoning is usually the result of ingestion to attempt suicide. Despite the fact that there have been a lot of experimental studies using intravenous or percutaneous injection of organophosphates, reports of human poisoning due to percutaneous injection are rare. The systemic signs of OPP have not been described in these reported patients. We report 2 cases having systemic signs of OPP due to percutaneous injection. In our first case, we noticed a 17-day muscle weakness and a 12-day muscarinic syndrome, which required prolonged atropinization. In the second patient, atropine infusion had to be continued for 2 days. Both cases also had severe swelling of the affected limb and wound infection. In conclusion, in cases of percutaneous injection of organophosphates systemic toxicity may develop in addition to local findings such as necrosis and abscesses. Close observation for evidence of systemic involvement is required, and the patient should be carefully monitored for secondary abscess formation and any delayed impairment of neurologic function.
authors.affiliation: Medical College of Akdeniz University, Antalya, Turkey. necmiyehadimioglu@hotmail.com
authors.forename: Necmiye
authors.initials: N
authors.lastname: Hadimioglu
authors.forename: Levent
authors.initials: L
authors.lastname: Dosemeci
authors.forename: Gulbrin
authors.initials: G
authors.lastname: Arici
authors.forename: Atilla
authors.initials: A
authors.lastname: Ramazanoglu
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D005260:Female; D005284:Fenthion / Q000506:poisoning*; D005355:Fibrosis; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D012883:Skin Ulcer / Q000139:chemically induced / Q000473:pathology; D013406:Suicide, Attempted / Q000523:psychology
chemical_list: D007306:Insecticides; D005284:Fenthion