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Intermediate syndrome in acute fenitrothion poisoning
1Department of Toxicology Collegium Medicum, Jagiellonian University, Kraków, Poland.
Przeglad Lekarski
|January 1, 1995
Summary
Fenitrothion organophosphate poisoning can cause a dangerous "intermediate syndrome" with delayed deterioration and respiratory failure, even with treatment. Higher pesticide levels correlate with poorer outcomes and prolonged acetylcholinesterase inhibition.
Area of Science:
- Toxicology
- Neuroscience
- Clinical Medicine
Background:
- Organophosphate pesticides, like fenitrothion, are associated with neurological syndromes.
- Intermediate syndrome following organophosphate exposure has unclear pathophysiology.
- Retrospective analysis is crucial for understanding clinical outcomes of poisoning.
Purpose of the Study:
- To investigate the clinical course and outcomes of fenitrothion oral intoxication.
- To explore the relationship between fenitrothion concentration, acetylcholinesterase (AChE) activity, and clinical presentation.
- To identify factors contributing to the development of intermediate syndrome.
Main Methods:
- Retrospective analysis of 16 patients with oral fenitrothion intoxication.
- Assessment of clinical status on admission, AChE activity, and blood fenitrothion levels.
- Review of treatment protocols including gastric lavage, atropine, and oximes.
Main Results:
- Six of 16 patients died, with delayed deterioration and moderate AChE inhibition despite treatment.
- Fatal cases showed high fenitrothion concentrations in blood and tissues.
- Seven of 10 survivors developed intermediate syndrome, characterized by delayed respiratory failure and persistent AChE inhibition.
Conclusions:
- Fenitrothion poisoning can lead to severe outcomes, including fatal intermediate syndrome.
- Delayed clinical deterioration and persistent AChE inhibition are key features of severe fenitrothion toxicity.
- Effective management requires close monitoring for delayed complications and prolonged AChE inhibition.