Citation

de Villiers P, Parker N, van Rensburg R, Goussard P, Marks C, Lorente VPF. Toxicol. Rep. 2024; 12: 18-22.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.toxrep.2023.12.001

PMID

38173652

PMCID

PMC10762317

Abstract

Methamidophos is a highly hazardous organophosphate and is known to cause an acute cholinergic toxidrome. Methamidophos use is not allowed in South Africa and therefore local data pertaining to methamidophos poisoning is very limited, with no paediatric clinical cases described. Methamidophos is an active metabolite of acephate, a commonly used organophosphate, registered for agricultural use in South Africa. We present a paediatric case of methamidophos poisoning with prolonged clinical effects. The patient experienced a prolonged cholinergic toxidrome lasting 10 days, with a period of near-full recovery during this time. We discuss the biological plausibility of the detected methamidophos being a byproduct of acephate. In addition, we highlight the importance of closer monitoring of patients with organophosphate poisoning in areas where acephate is commonly used.

Language: en

Keywords

Dermal absorption; Methamidophos; Organophosphate; Paediatrics; Prolonged cholinergic syndrome