Prolonged Intermediate Syndrome Due to Organophosphate Poisoning

Abstract

Organophosphate poisoning can present as acute cholinergic syndrome, Intermediate syndrome and delayed neuropathy. Intermediate syndrome secondary to organophosphate poisoning is a serious health problem leading to increased morbidity and mortality. The incidence of problem varies and range from 8%-84% of organophosphate poisoning cases. The factors account for this difference is nature of organophosphate compound, severity of poisoning and inadequate Oxime therapy. The recognition of this syndrome is important as organophosphate poisoning is common in our country. We presented this case of organophosphate poisoning leading to prolonged intermediate syndrome. The muscle weakness associated with this syndrome generally resolves in 5-18 days but in our case this lasted for 23 days. After a prolonged Intensive Care Unit (ICU) stay patient was discharged home with no residual symptoms. The case highlights anticipation and recognition of this problem after cholinergic crisis is over.