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Rare Homicidal Organophosphorus Poisoning in a Neonatal Twins

Jagan Mohan Varakala, Sekhar Visalvath, Dayanand Reddy

Organophosphate (OP) compounds widespread use throughout the world, mainly in agriculture, may cause serious life-threatening conditions. We report the case of neonatal twins presented with poor feeding, lethargy, jerky respiration and excessive frothy secretions, pinpoint pupils and bradycardia. Father disgruntled over his wife giving birth to twin girls, attempted to poison the new born twin females and landed himself behind the bars. The symptoms appeared and poisoning was confirmed by hospital authorities by CCTV at the delivery center and was referred to our Hospital.

Diagnosis of OP poisoning based on history of exposure, characteristic clinical manifestations of toxicity. Management consists of airway support ventilation, fluid resuscitation as well as atropine incremental doses and antidote Pralidoxime. Clinical suspicion and prompt specific treatment save lives without any sequelae.

Plasma pseudo cholinesterase analysis is a cost effective and a reliable indicator for organophosphate intoxications and could be used for confirmation and therapeutic monitoring.

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