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Alcohol and Alcoholism Advance Access originally published online on August 1, 2008
Alcohol and Alcoholism 2008 43(6):650-652; doi:10.1093/alcalc/agn063
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© The Author 2008. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved

Ethanol Poisoning Together with Organophosphate Exposure: A Difficult Clinical Diagnosis Because of Physician Anchoring

Yi Li*, Xuezhong Yu, Zhong Wang and Houli Wang

The Emergency Department, Peking Union Medical College Hospital, Beijing, China

* Corresponding author: The Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Tsinghua University, Beijing 100730, China. Tel.: +86-13693-109826; Fax: +86-10652-95301; E-mail: billliyi{at}yahoo.com

Received 18 March 2008; first review notified 12 June 2008; in revised form 26 June 2008; accepted 4 July 2008; advance access publication 1 August 2008


  Abstract

Aims: Organophosphorus pesticide poisoning occurs frequently in China and can be diagnosed easily based on the history of ingestion and the cholinergic toxic syndrome. Yet, when combined with other toxins, organophosphorus poisoning may appear different. Methods: Here, we present a case of acute ethanol poisoning together with a dermal organophosphorus exposure. Results: Based on the history and a misinterpretation of the physical examination, the patient was treated as an organophosphorus poisoning. Ultimately, serum analysis helped clarify the diagnosis. Conclusions: Toxicologist should be aware of the error known as anchoring and take appropriate precautions to limit its occurrence.


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