Organophosphorus poisoning: the wet opioid toxidrome

In The Lancet, David Steindl and colleagues describe the case of a 44-year-old man who was poisoned by a novichok organophosphorus nerve agent.1 The man was a passenger on a domestic flight in Russia when he became confused, and vomited and collapsed unconscious; 2 h later, he was hospitalised in Omsk, Russia, and treated for respiratory failure and coma. After transfer by air ambulance to Berlin, Germany, features of the cholinergic toxidrome (ie, small or pinpoint pupils, bradycardia, sweating, and hypersalivation) allowed a diagnosis of organophosphorus poisoning to be made.