We report a patient in whom intoxication with a commercial preparation of malathion led to a severe acute cholinergic crisis, protracted cardiac arrhythmias, an acute respiratory distress syndrome, and an acute sensorimotor axonal polyneuropathy. The occurrence of the polyneuropathy was associated with a novel malathion transformation product, S-(1-ethoxycarbonyl, 2-isopropoxycarbonyl) ethyl 0,0-dimethyl phosphorodithioate (isopropylmalathion), an impurity present in the pesticide residue. The role of isopropylmalathion in the pathophysiology of the polyneuropathy remains to be determined.
Monje Argiles, A., Lison, D., Lauwerys, R., Mahieu, P., Brucher, J.-M., & Van den Bergh, P. (1990). Acute polyneuropathy after malathion poisoning. Acta Neurologica Belgica, 90(4), 190-199. https://hdl.handle.net/2078.5/134222 (Original work published 1990)