From Itching to Poisoning: The Deadly Cost of Misguided Pest Control in Iran’s Households, A Case Report

Background: Pediculosis, or lice infestation caused by Pediculus humanus capitis, is a common parasitic condition affecting children worldwide, including in Iran. This case report focuses on a ۳-year-old girl who experienced acute organophosphate poisoning due to the misuse of an organophosphate pesticide for treating pediculosis.Case Presentation: The child's mother applied an organophosphate spray (Diazinon) to the child's scalp to treat the lice infestation. Within minutes of application, the child began exhibiting symptoms of poisoning, leading to her hospitalization in the emergency department. Upon arrival, the child was evaluated for vital signs and clinical symptoms, including excessive sweating, shortness of breath, nausea, and increased salivation. The treatment regimen included the administration of atropine, pralidoxime, and supportive care. On clinical examination, the child's vital signs were stable. However, laboratory tests revealed significantly low cholinesterase levels. The serum cholinesterase level was ۱۲۰۰ IU/lit (normal range > ۴۰۰۰ IU/lit), and the RBC cholinesterase level was ۰.۷ IU/lit (normal range > ۴ IU/lit). These findings confirmed the diagnosis of organophosphate poisoning. The child was treated with atropine, pralidoxime, and supportive management, and after ۴۸ hours, her condition improved, and she was discharged in stable health.Conclusion: This case report highlights the serious consequences of improper use of chemical pesticides, especially in households without adequate knowledge or access to proper medical facilities. The report emphasizes the importance of safe treatment options for pediculosis, such as topical permethrin, and calls for greater awareness and education on the risks associated with misusing harmful chemicals. Effective management of pediculosis should involve safe, accessible treatment alternatives and targeted educational efforts to prevent the misuse of dangerous substances in the home.

کلیدواژه ها:

Children ، Cholinesterase ، Organophosphate ، Poisoning ، pesticide safety