Publication: The "intermediate syndrome" as critical sequelae of organophosphate poisoning: The first report of two cases in Thailand
Issued Date
2005-09-01
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ISSN
01252208
01252208
01252208
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2-s2.0-31544473467
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.88, No.9 (2005), 1308-1313
Suggested Citation
Winai Wananukul, Sumalee Kiateboonsri, Thithapandha The "intermediate syndrome" as critical sequelae of organophosphate poisoning: The first report of two cases in Thailand. Journal of the Medical Association of Thailand. Vol.88, No.9 (2005), 1308-1313. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/16841
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Title
The "intermediate syndrome" as critical sequelae of organophosphate poisoning: The first report of two cases in Thailand
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Abstract
The authors report 2 cases of organophosphate poisoning which developed intermediate syndrome. The first case was a man who took an organophosphate insecticide, monocrotophos, and developed severe organophosphate poisoning. Respiratory support was needed. He was treated with atropine and 2-PAM. Weakness of neck muscles, proximal limb and respiratory muscle developed in the 3 rd day after ingestion. By supportive treatment and careful monitoring, however, he recovered after 11 days of the poisoning. The second case was a lady who took dicrotophos. She developed severe organophosphate poisoning for which respiratory support was also needed. High dose of atropine, but without 2-PAM, was administered. She developed bulbar palsy, proximal muscle and respiratory weakness 3 day after the ingestion. Ventilation support was needed for 13 days before weaning was successful. This report did not support an efficacy of pralidoxime (2-PAM) in alleviation of the intermediate syndrome, but aims to alert physicians to recognize the intermediate syndrome for which adequate respiratory care is the crucial key for its management.