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Organophosphate Toxicity Presenting as a Stroke Alert
Martin J Morales-Cruz1, Bridget Scheveck1, Vanessa I Diaz1
1Emergency Medicine, HCA Florida Osceola Hospital, Kissimmee, USA.
Cureus
|May 2, 2023
Summary
Altered mental status can mimic stroke. Organophosphate poisoning, though rare, should be considered in patients with miosis and bradycardia unresponsive to naloxone.
Area of Science:
- Toxicology
- Emergency Medicine
- Neurology
Background:
- Altered mental status (AMS) is a frequent emergency department (ED) presentation with a wide differential diagnosis.
- Diagnosing AMS is challenging when patients cannot provide a history and collateral information is limited.
Observation:
- A case of AMS initially suspected as a stroke alert was presented.
- The patient's condition was later identified as intentional organophosphate ingestion.
Findings:
- Organophosphate poisoning, while uncommon in the U.S., presents with specific signs.
- Key indicators include miosis, bradycardia, and copious secretions.
- Patients with these symptoms unresponsive to naloxone warrant consideration for organophosphate toxicity.
Implications:
- This case highlights the importance of considering less common toxicological causes of AMS.
- Early recognition of organophosphate poisoning is crucial for appropriate management and improved patient outcomes.
- Clinicians should maintain a broad differential for AMS, including toxic ingestions.
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