Return to Spontaneous Circulation in a Patient With Cholinergic Syndrome at the Emergency Department of Buea Regional Hospital, Cameroon

Abstract

With the increasing misuse of herbal treatment and pesticides, cases of cholinergic syndrome following herbal treatment or organophosphate poisoning have become increasingly common in our milieu. However, when advanced, mortality is high. We report the successful management of a case involving a 54-year-old African female with a known history of hypertension and people living with HIV/AIDS, who consumed a powdered concoction from a traditional herbalist with the aim of treating her hypertension. She was later found unconscious and brought to the Emergency Department. On arrival, clinical evaluation revealed an unconscious patient, gasping, with bradypnea and hypersalivation. A working diagnosis of cholinergic syndrome was made. She was intubated and treated with atropine and recovered one hour later, after which she was extubated and admitted to the intensive care unit (ICU) for supportive intensive care treatment. She was discharged 2 days after her admission to the ICU with counseling to take only medications prescribed by a medical doctor to avoid this situation in the future. Our case report shows that prompt and accurate therapy in the face of advanced organophosphate poisoning can lead to the rescue of life.