JOEL B. MANN, M.D.
A recent report (1) of the undiagnosed, untreated death of 86% of patients with acute parathion intoxication underscores the need for the rapid diagnosis of organophosphate poisoning. The initial clues must be clinical, and, even should no history be obtainable, the classic findings of parasympathetic hyperactivity, that is, miosis, salivation, profuse pulmonary secretions, cyanosis, and bradycardia, should suggest intoxication with an anticholinesterase.1
Laboratory confirmation of organophosphate intoxication is critically important since the carbamates, a class of cholinesterase inhibitors in which therapy with pralidoxime chloride is contraindicated (3), induce a similar clinical presentation (3, 4). Plasma cholinesterase activity, as measured by
MANN JB. Diagnostic Aids in Organophosphate Poisoning. Ann Intern Med. ;67:905–906. doi: 10.7326/0003-4819-67-4-905
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Published: Ann Intern Med. 1967;67(4):905-906.
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