Atypical manifestations of organophosphorus poisoning following subcutaneous injection of Dichlorvos with suicidal intention

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
ISSN
0972-5229
DOI
10.4103/0972-5229.130578
Volume
18
Issue
4
Publishing Year
2014
Pages
3
Article keywords
Central nervous system manifestations, respiratory arrest, subcutaneous dichlorvos

Abstract

Current case report describes a 37-year-old female patient who was admitted to the hospital following subcutaneous injection of Dichlorvos with an insulin syringe. The only peripheral cholinergic sign observed on admission was excessive salivation with bilateral pyramidal tract signs. Locally she had necrosis of skin and subcutaneous tissue with surrounding blisters. In the subsequent course of her illness, she developed respiratory arrest requiring ventilator support. She also had delayed extrapyramidal manifestations. Relevant literature is reviewed. Possibility of route-specific, delayed predominant central nervous system effect of Dichlorvos postulated.

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