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We discuss a case of a 17-year-old white male who intentionally ingested a tick and flea insecticide and was admitted to the emergency room unconscious, with signs and symptoms of cholinergic toxicity. Capillary gas chromatography and electron-impact mass fragmentographic analysis of the patient's urine and serum demonstrated the presence of poly-ethylene glycol and propoxur (o-isopropoxyphenyl N-methyl-carbamate), a carbamate-based cholinesterase inhibitor commonly used in insecticides. The patient fully recovered, but only after a complicated hospital course. We also discuss the laboratory assessment and clinical treatment of poisoning with carbamate and organophosphate insecticides.
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Remaley et al. (1988) studied this question.
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