title: A case of organophosphate poisoning presenting with seizure and unavailable history of parenteral suicide attempt.
abstract: Organophosphate (OP) poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis.
authors.affiliation: Department of Medicine, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Pandit
authors.forename: Shubha
authors.initials: S
authors.lastname: Seshadri
authors.forename: S N
authors.initials: SN
authors.lastname: Rao
authors.forename: Charmaine
authors.initials: C
authors.lastname: Samarasinghe
authors.forename: Ashwini
authors.initials: A
authors.lastname: Kumar
authors.forename: Rohith
authors.initials: R
authors.lastname: Valsalan