Coma, Crisis, and Cure: A Pediatric Case of Severe Amitraz Poisoning Managed Supportively: A Case Report

INTRODUCTION: Amitraz is a formamidine acaricide and insecticide, commonly used in agriculture for crop protection and in veterinary medicine to control ectoparasites in animals. It primarily acts as an agonist at central α2-adrenergic receptors. It also inhibits intracellular adenylate cyclase enzyme and decreases cAMP concentration. Clinically, it may cause bradypnea, bradycardia, hypothermia, hypotension, and hyperglycemia as early as 30 minutes after ingestion. And recovery is expected within 48 to 72 hours. Most cases of Amitraz poisoning share overlapping clinical features with Organophosphate poisoning, and since both are commonly reported as pesticides, this often leads to diagnostic confusion and subsequent risk of mismanagement. CASE PRESENTATION: We report an 11-years-old child who took an unquantified amount of Amitraz for a suicidal attempt, presented with coma and respiratory depression. He was successfully managed with respiratory support and discharged within 72 hours. Amitraz is currently the most widely available insecticide in developing nations, so understanding its toxic effects on normal human physiology and the immediate interventions required are very important. The case initially presented with agitation for stimulus, which is an atypical presentation of Amitraz. CONCLUSION: This case report highlighted the need for an organized, algorithm-based toxidrome approach when confirming the specific agent is challenging. Also, child psycho-social support has a big part in preventing preventable death.