South African Medical Journal/Suid-Afrikaanse Mediese Tydskrift 2012-04-01

Does the nose know? Amitraz poisoning and olfaction.

Andy Parrish, Ruth Lancaster

Index: S. Afr. Med. J. 102(4) , 223-4, (2012)

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Abstract

The initial clinical presentation of amitraz and organophosphate poisoning may be similar. Reduced serum pseudocholinesterase supports a diagnosis of organophosphate toxicity, but there is no similar laboratory test for amitraz poisoning. A 'mothball-like' odour associated with poisoned patients may have diagnostic potential. In a blinded controlled trial, 83% (95% confidence interval, 63% to 93%) of 23 healthcare workers were able to distinguish between the odours of amitraz and organophosphate. Awareness of this simple component of bedside examination may allow earlier recognition of this potentially fatal poisoning.