Poisoning by Organophosphate Pesticides: A Case Report

Abstract

In many parts of the world, particularly in impoverished nations like Ethiopia, organophosphate compounds operate as suicide agents, are frequently employed as pesticides, and are strong inhibitors of the acetylcholinesterase enzyme. A 21-year-old Ethiopian female, a university student, was admitted to an emergency department on June 22, 2022, with a two-hour history of nausea and elevated secretions of salivation via the mouth. She had no previous history of psychiatric or neurological disorders, but three days before her admission, she quarreled with her boyfriend, became extremely depressed, and decided to commit suicide. She had a two-hour history of nausea and intermittent vomiting and a one-hour history of persistent vomiting, increased salivation secretions through the mouth, chills, progressive sweating, difficulty breathing, and dizziness. Upon admission, her neurological examination in the emergency department revealed a Glasgow Coma Scale score of 9/15. On admission, she was placed on two liters per minute of intranasal oxygen via the nasal cannula. On the same day, she was given atropine 0.15 mg intravenously, and the dose was doubled every 10 minutes until atropinization was achieved, and a bolus dose of 500ml of 0.9% of normal saline was initiated immediately.

Keywords: acetylcholinesterase enzyme; an emergency department; atropine sulfate; case report; organophosphate pesticide poisoning.