Organophosphorus Compound Induced 'intermediate syndrome

Background: organophosphate compound (opc) poisoning with suicidal intent is common in indian icus. these compoundsare the organic derivatives of phosphorous containing acids and their effect on neuromuscular junction and autonomic synapsesis clinically important. organophosphate poisoning can present as acute cholinergic syndrome, intermediate syndrome anddelayed neuropathy.case presentation: intermediate syndrome secondary to organophosphate poisoning is a serious health problem leading toincreased morbidity and mortality. the incidence of problem varies and ranges from 8%-84% of opc poisoning cases. afterinitial recovery from cholinergic crisis, some patients have resurgence of respiratory muscle paralysis requiring continuedventilatory support. this is termed intermediate syndrome (ims). the factors accounting for this difference is the nature oforganophosphate compound, severity of poisoning and inadequate oxime therapy. the recognition of this syndrome is importantas if this entity is overlooked it can have disastrous effects.discussion: our patient had developed respiratory muscle weakness as evidenced by inadequate respiratory efforts, drop inoxygen saturation, retention of co2 and need for ventilatory support. there was no evidence of weakness in ocular, neck, bulbarmuscles but he had weakness in all 4 limbs more pronounced in proximal muscles.conclusion: we presented this case of opc poisoning with intermediate syndrome, which remained for a prolonged time andrequired mechanical ventilation for 16 days. this case highlights how the timely intervention can save the patient’s life.