We report 2 cases of organophosphate poisoning which developed intermediate syndrome. The first case was a male who took an organophosphate insecticide, and developed severe organophosphate poisoning. Respiratory support was needed. He was treated with atropine and 2-PAM.This was followed by weakness of neck muscles, proximal limb and respiratory muscle. By supportive treatment and careful monitoring, however, he recovered. The second case was a lady who developed severe organophosphate poisoning for which respiratory support was also needed. High dose of atropine, and PAM, was administered. She developed bulbar palsy, proximal muscle and respiratory weakness after the ingestion. Ventilation support was needed before weaning was successful. This report aims to alert physicians to recognize the intermediate syndrome for which adequate respiratory care is the crucial key for its management.
Organophosphate, bulbar palsy, proximal muscle weakness, Respiratory failure
