Delayed Effects of Transcutaneous Organophosphate Poisoning in Four Children

Area of Science:

• Toxicology
• Pediatric Medicine
• Environmental Health

Background:

• Transcutaneous absorption of organophosphates (OP) is an infrequently reported route of poisoning.
• Limited case reports exist regarding the clinical presentation and management of OP poisoning via skin contact.
• Understanding variable clinical manifestations is crucial for accurate diagnosis and timely intervention.

Purpose of the Study:

• To report a rare case series of organophosphate (diazinon) poisoning in children resulting from transcutaneous absorption.
• To describe the uncommon, delayed clinical presentation characterized by nicotinic and neuropathic effects.
• To enhance awareness and understanding of the transcutaneous route of OP intoxication.

Main Methods:

• Case report of four children from the same family with suspected organophosphate poisoning.
• Diagnosis based on temporal proximity of illness onset, parental interviews, and exclusion of other differential diagnoses.
• Clinical observation focusing on delayed signs and symptoms following suspected skin contamination.

Main Results:

• Diagnosis of transcutaneous organophosphate (diazinon) intoxication confirmed in four siblings.
• Exposure occurred during a game involving a recently used poison can.
• Clinical picture included delayed nicotinic effects (muscle weakness, cramps) and subtle neuropathic features developing over weeks.

Conclusions:

• This case series underscores the possibility of significant organophosphate poisoning through transcutaneous absorption, even with uncommon presentations.
• Delayed neurological and neuromuscular effects can manifest weeks after initial skin exposure.
• Increased clinical awareness of this rare exposure route is vital for prompt diagnosis and management of organophosphate poisoning in pediatric populations.