Zusammenfassung
Wir berichten über den seltenen Fall eines 27jährigen Mannes, der sich in suizidaler Absicht 30 ml Metasystox® (Demeton-S-methyl) intravenös appliziert hatte. Neben der raschen Entwicklung der akuten cholinergen Symptome, kam es zu einer frühzeitigen lokalen Infektion im Injektionsbereich der linken Cubitalvenen, die einen chirurgischen Eingriff mit ausgedehntem Débridement erforderlich machte. Der Patient entwickelte in der dritten Behandlungswoche eine Rhabdomyolyse mit akutem Nierenversagen sowie einen Anstieg der Leberenzyme. Abschließend zeigte sich als neurologische Manifestation der Organophosphat-Vergiftung ein Intermediärsyndrom.
Abstract
A 27-year old man was admitted to the hospital after having attempted suicide by injection of 30 ml of metasystox (demeton-s-methyl), an organophosphate compound, in a cubital vein of the left arm. He was suffering from the typical cholinergic symptoms. Local examination of the injection site revealed a local inflammation extending from the middle of the left upper arm to the distal forearm. Surgical débridement became necessary. In the third week of treatment he developed a rhabdomyolysis (CK 66.300 U/l) with an acute renal failure and needed haemodialysis. Later he showed signs of an intermediate syndrome.
Schlüsselwörter
Metasystox - Organophosphate - Intravenös - Rhabdomyolyse - Akutes Nierenversagen - Intermediärsyndrom
Key words
Metasystox - Organophosphate - Intravenous - Rhabdomyolysis - Acute renal failure - Intermediate syndrome
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Dr. Oliver Volk
Medizinische Klinik I, Klinikum Krefeld
Lutherplatz 40
47805 Krefeld
Email: o.volk@freenet.de
