Non-traumatic rhabdomyolysis associated with organophosphate intoxication h
as not been generally reported. We report here in a severe case of fenitrot
hion poisoning complicated by rhabdomyolysis. A 43-year-old woman ingested
approximately 100 ml of fenitrothion emulsion (50%) in an attempt to commit
suicide. On day 3 after admission, her creatine phosphokinase (CPK) peaked
at 47,762IU/L. She received supportive treatment included sodium bicarbona
te and fluid resuscitation, However, muscarinic symptoms including excessiv
e miosis and salivation developed on day 5 when her CPK levels decreased. T
he delay in cholinergic symptoms might have been due to the trihexyphenidyl
she took with the antipsychotic drugs. Fortunately, the present patient re
covered from the acute cholinergic crisis, and acute renal failure was prev
ented by early diagnosis. This is a case of organophosphate poisoning compl
icated by rhabdomyolysis in a psychiatric patient. The masking of acute cho
linergic symptoms should be taken into consideration in such patients.