Critical Management in a Resource-Limited Setting of Amitraz Overdose Case Report

Abstract

Background: Amitraz poisoning, though rare, poses significant health risks, particularly in developing regions like Africa where its use as an insecticide and acaricide is widespread. 

Case Presentation: A 24-year-old female in Southwest Uganda was brought to the Emergency Department after intentional ingestion of Amitraz. Initial assessment revealed somnolence, bradycardia, hypotension, and respiratory distress. Despite decontamination, intravenous fluids, and atropine administration, the patient's condition deteriorated, necessitating intubation and transfer to an ICU. 

Discussion: Amitraz toxicity manifests primarily through central α2 adrenergic receptor agonism, resembling clonidine overdose, with symptoms including hypotension, bradycardia, altered mental status, and respiratory depression. Differentiating Amitraz poisoning from organophosphate toxicity is crucial due to overlapping clinical features but distinct management strategies. Supportive care, including airway management and cardiovascular support, is essential. 

Conclusion: This case highlights the critical need for awareness and preparedness for Amitraz poisoning in resource-limited settings. Effective supportive care can lead to successful outcomes despite severe initial presentations. Further education and preventive measures are recommended to mitigate risks, especially among vulnerable populations.