Case report on impending respiratory failure due to allerged organophosphorus compound poisoning (CHLORPYRIFOS)

Abstract

In many parts of the world, particularly in impoverished nations, organophosphate compounds in few incidences operate as suicide agents, are frequently employed as pesticides which are strong inhibitors of the acetylcholinesterase enzyme. A 43year-old male, was admitted to an emergency department at 9:00am, with a two-hour history of nausea and elevated secretions of salivation via the mouth. He had no previous history of psychiatric or neurological disorders but with extreme causes of Respiratory Failure due to COVID-19. On three days before his admission, he quarrelled with his wife, became extremely depressed, and decided to commit suicide. He had a two-hour history of nausea and intermittent vomiting, diarrhoea and a one-hour history of persistent increased vomiting, increased salivation secretions through the mouth, chills, progressive sweating, difficulty breathing, and dizziness. Upon admission, his neurological examination in the emergency department revealed a Glasgow Coma Scale score of 9/15. On admission, he was placed on two litres per minute of intranasal oxygen via the nasal cannula. On the same day, Hewas treated by gastric lavage and administered atropine 0.15 mg intravenously, and the dose was doubled every 10 minutes until atropinisationwas achieved, and a bolus dose of 500ml of 0.9% of normal saline was initiated immediately.