[Clinical aspects, analysis and follow-up of poisoning with the alkyl phosphate demeton-S-methylsulfoxide (Metasystox R)].

We report on a 52-year old woman who had taken an unknown dose of the organophosphate insecticide Metasystox R with suicidal intention. Ingestion was followed by cardio-respiratory failure. After successful cardio-pulmonary resuscitation, main therapeutic principles were the immediate application of atropine and decontamination procedures such as gastric lavage, induction of diarrhoea and instillation of carbon. A single combined haemoperfusion and haemodialysis treatment was performed as a secondary elimination technique. After rapid toxicological analysis, obidoxime was administered as a supplementary antidote. After 14 days of treatment, the patient could leave the ICU with a complete restitution. Our case report demonstrates the efficiency of immediate application of antidotal therapy (atropine), decontamination and elimination techniques even in case of cardio- respiratory failure after organophosphate poisoning. Toxicological analysis will be beneficial for diagnosis and the indication of further treatment with obidoxime.