Successful treatment of intermediate syndrome in a COVID-19 patient with severe organophosphate toxicity

Marwa Mohammed Fouad; Nermin Hamdy Zawilla; Doaa Atef Moubarez

doi:10.4103/ijciis.ijciis_84_22

Successful treatment of intermediate syndrome in a COVID-19 patient with severe organophosphate toxicity

Int J Crit Illn Inj Sci. 2023 Jul-Sep;13(3):145-147. doi: 10.4103/ijciis.ijciis_84_22. Epub 2023 Sep 21.

Authors

Marwa Mohammed Fouad¹, Nermin Hamdy Zawilla^{1

2}, Doaa Atef Moubarez³

Affiliations

¹ Department of Occupational and Environmental Medicine, Cairo University, Cairo, Egypt.
² Department of National Environmental and Clinical Toxicology Research Center, Cairo University, Cairo, Egypt.
³ Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract

Organophosphate (OP) poisoning is one of the most common causes of poisoning in the world, due to its easy availability, low cost, and wide occupational exposure. It has a significant death and morbidity rate. Cholinergic syndrome, intermediate syndrome (IMS), and syndrome of delayed polyneuropathy are the three primary syndromes that define OP poisoning. We report the case of a 44-year-old male patient who had a history of OP poisoning by inhalation and later developed altered mental status (AMS). The patient transiently improved and regained consciousness following treatment with atropine and obidoxime. He deteriorated the following day with AMS and generalized muscle weakness consistent with IMS and was intubated for airway protection. Despite further complication by Klebsiella and COVID-19 infections, he recovered to hospital discharge on day 14.

Keywords: Case report; intermediate syndrome; occupational exposure; organophosphates; poisoning.

Publication types

Case Reports