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Delayed recovery from unusual and late-onset complications of organophosphate poisoning
Self-poisoning with organophosphate (OP) pesticides has become a serious problem in developing countries. OPs inhibit acetylcholinesterase, leading to the accumulation of acetylcholine, which, in turn, leads to autonomic, somatic and central nervous system malfunction. The clinical features of OP toxicity are defined as acute cholinergic crisis; other manifestations include intermediate and delayed polyneuropathy. Here, we report a case of a 75-year-old man who allegedly intentionally ingested OP insecticide and who presented with cardiac arrest complicated by intermediate syndrome and delayed organophosphorusinduced polyneuropathy. All complications occurred during the course of management, for example unusual complete heart block and late onset of complete limb paralysis reported in this case. This report highlights uncommon complications of OP poisoning and that early awareness of these complications by the physicians and intensive supportive treatment is the key to successful management.