1Professor and Head, Department of Emergency Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir
2Senior Resident, Department of Emergency Medicine, Sher-i Kashmir- Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
3Resident, Department of Emergency Medicine, Sher-i Kashmir- Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
4Post-graduate Student, Department of Internal Medicine, Sher-i Kashmir- Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
Organophosphate (OP) poisoning caused by pesticide-contaminated food is seldom reported.
We report an incident of OP poisoning, in an 18 year old female. She had consumed a large amount of unwashed cherries from the garden, after a religious fast whole day. Next morning she was found unconscious, soiled in stools and urine and had frothing at mouth and nostrils. Patient had developed “Hypersecretory syndrome” with bilateral pin point pupils. She was in shock with GCS of E1(7/15). She had type 1 respiratory failure (sO2=50%), requiring intubation. After aggressive V1M5 supportive management and atropine patient recovered from shock and was able to maintain oxygen saturation on room air. Later, patient developed “Intermediate syndrome” in the form of peripheral neuropathy and areflexia. She also developed Atropine psychosis, during treatment.
On further investigations it was found that Dichlorvos (Nuvan) was sprayed on cherries few days back and her plasma cholinesterase levels were < 1 micro U/L (Normal range – 3.93 – 7.80 řU/L).
Organo-phosphorus poisoning, OP contaminated cherries, intermediate syndrome, hyper-secretory syndrome, atropine toxicity
