A Case of Amitraz Poisoning Initially Misdiagnosed as Acute Organophosphate Insecticide Poisoning

ABSTRACT

Amitraz is acaricidal and insecticidal pesticide used worldwide to control ticks and mites in plants and animals. Amitraz poisoning is characterized by clinical toxidrome such as central nervous system, respiratory depression, bradycardia, hypotension, hypothermia, and hyperglycemia. Toxic mechanism of amitraz is mainly alpha2-agonistic function and poisonings may occur by any route. Such clinical symptoms and signs of acute amitraz poisoning were possible to be thought as a toxidrome of acute organophosphate poisoning. We reported a 68-year-old woman that initially was misdiagnosed as acute organophosphate poisoning on the ground of symptoms and signs of mental change, respiratory depression, bradycardia, and hypotension. However, the serum level of pseudocholinesterase level at emergency room admission was within normal level and a vacant bottle of amitraz pesticide was founded around the yard of the patient. The patient was totally recovered from acute amitraz poisoning 2 days later after mechanical ventilation and conservative cares including atropine injection.