Diagnosis by nose.
Poisoning (Care and treatment)
Amitraz (Complications and side effects)
|Publication:||Name: South African Medical Journal Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 South African Medical Association ISSN: 0256-9574|
|Issue:||Date: April, 2012 Source Volume: 102 Source Issue: 4|
|Product:||Product Code: 8000420 Diagnostic Procedures NAICS Code: 6215 Medical and Diagnostic Laboratories|
|Geographic:||Geographic Scope: South Africa Geographic Code: 6SOUT South Africa|
In an era where a patient's medical history and physical
examination may play second fiddle to a battery of biochemical and
imaging tests, Parrish and Lancaster (2) refreshingly return to basics
and provide an olfactory diagnostic clue.
Amitraz is an agricultural insecticide and veterinary pesticide used to treat ectoparasite infections in animals. Human poisoning may be accidental or deliberate. The initial clinical presentation of amitraz and organophosphate poisoning may be similar; however, their management is different. Patients present with nausea, vomiting, bradycardia, and either miosis or mydriasis. Reduced serum pseudocholinesterase supports a diagnosis of organophosphate toxicity, but there is no similar laboratory test for amitraz poisoning. Amitraz and its metabolites or solvents may contribute to a characteristic 'mothball-like' or 'dry-cleaning' odour in the poisoned patient, which is often particularly noticeable on endotracheal suctioning.
The authors, in a blinded trial, tested 23 volunteer healthcare workers on their ability to distinguish between the odours of amitraz, organophosphate and distilled water; 83% were able to distinguish between these odours. They conclude that this simple component of bedside examination may allow earlier recognition of this potentially fatal poisoning. Severely ill patients should receive prompt vigorous resuscitation and support.
|Gale Copyright:||Copyright 2012 Gale, Cengage Learning. All rights reserved.|