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Carbamate poisoning in early childhood and in adults
M Lifshitz1, E Shahak, A Bolotin
1Toxicology Unit, Soroka Medical Center, Beer-Sheva, Israel.
Insights
Carbamate poisoning in children presents differently than in adults, with central nervous system depression being more common in young patients. This highlights the need for careful diagnosis in pediatric carbamate poisoning cases.
Area of Science:
- Toxicology
- Pediatric Medicine
- Clinical Chemistry
Background:
- Carbamate pesticides are widely used, posing a risk of poisoning.
- Understanding age-specific toxicity is crucial for effective treatment.
Purpose of the Study:
- To compare the clinical manifestations of carbamate poisoning in young children and adults.
- To identify key differences in symptom presentation between pediatric and adult cases.
Main Methods:
- Retrospective analysis of 36 children (1-8 years) and 24 adults (17-41 years) with confirmed carbamate poisoning.
- Gas chromatography-mass spectrometry identified ingested methomyl or aldicarb.
- Clinical symptoms were compared based on serum cholinesterase levels.
Main Results:
- Children predominantly exhibited central nervous system depression and hypotonia.
- Diarrhea was the most frequent muscarinic effect in children.
- Adults more commonly presented with miosis and fasciculations; CNS depression was rare.
Conclusions:
- Clinical presentation of carbamate poisoning significantly differs between young children and adults.
- Central nervous system depression in children may indicate carbamate poisoning even without classic muscarinic signs.
Objective:
Retrospective evaluation of the clinical course of carbamate poisoning in young children and adults.
Design:
Thirty-six children aged 1 to 8 years (median 2.5 years) and 24 adults aged 17 to 41 years (median 22 years) ingested rat poison resulting in carbamate poisoning. The ingested poisons in all cases were positively identified as methomyl or aldicarb by gas chromatography-mass spectrometry.
Results:
Symptoms of intoxication in children were compared to those in adults with similar depression of the serum cholinesterase. The predominant symptoms in young children were central nervous system depression and hypotonia. The most common muscarinic effect was diarrhea. In adults, the main signs were miosis and fasciculations. Fasciculations in children were less frequent. Central nervous system depression, hypotonia, and diarrhea were uncommon in adults.
Conclusion:
Based on a relatively large number of carbamate poisonings in young children, we conclude that the clinical presentation differs from adult poisoning manifestations. The absence of classic muscarinic effects does not exclude the possibility of carbamate poisoning in young children with central nervous system depression.