Abstract
Without any information of posoning, an unconscious case of organophosphorus poisoning is sometimes difficult to be dif f erenciated from that of cerebrovascular disease and was rarely reported without information of poisoning. We report a case of uninformed organophosphorus poisoning, with our diagnosing process and treatments.
58 year-old female was admitted by ambulance because of unconsciousness, tetraparesis and respiratory disturbance. She was initially suspected of cerebrovascular disease. She showed, however, severe metabolic acidosis in spite of neither episode of diabetes mellitus nor renal disease. This made us suspect of poisoning. Gastric tube was inserted and milky aromatic fluid was drainaged. We asked the family to find any evidence of poisoning and they finally found a empty can of Sumithion (fenitrothion) in the corner of the bath room. As extremely low level of plasma cholinesterase was revealed, we diagnosed as Sumithion posoning. In spite of the delay of treatment for organophosphorus poisoning, the patient was administered under appropriate respiratory and circulatory management and was discharged without any neurological deficits.
