A tale of three mimickers: Amitraz, fipronil, and 2,4‑dichlorophenoxyacetic acid poisoning confounding organophosphate toxicity
Keyur Savjibhai Bhimani
, Varsha Shinde, Pratik Kanani, Joshua Daniel Birru, Mohammed Arif Abdul Salam
Department of Emergency Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
Keywords: 2,4‑dichlorophenoxyacetic acid toxicity, amitraz poisoning, cholinergic toxidrome, emergency medicine, fipronil toxicity, organophosphate mimickers, pesticide poisoning, toxicology
Abstract
Organophosphates (OP) and carbamates frequently cause acute poisoning worldwide via acetylcholinesterase inhibition, leading to characteristic cholinergic toxidrome manifestations. However, some agents such as Amitraz, Fipronil, and 2,4 dichlorophenoxyacetic acid act through different mechanisms yet clinically mimic OP poisoning, complicating diagnosis and management. This case series presents three patients exposed to these mimickers, highlighting differing clinical features, investigations, and management strategies. Recognizing these pesticide mimickers is critical to avoid inappropriate therapy and optimize outcomes.
How to cite this article: Bhimani KS, Shinde V, Kanani P, Birru JD, Salam MA. Atale of three mimickers: Amitraz, fipronil, and 2,4‑dichlorophenoxyacetic acid poisoning confounding organophosphate toxicity. Turk J Emerg Med 2026;26:248-51.
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
• Conceptualization – Dr. Pratik Kanani, Dr. Keyur Bhimani
• Investigation – Dr. Varsha Shinde, Dr. Keyur Bhimani, Dr. Mohammed Arif Abdul Salam
• Writing – original draft – Dr. Keyur Bhimani, Dr. Pratik Kanani
• Writing – review and editing – Dr. Varsha Shinde, Dr. Mohammed Arif Abdul Salam, Dr. Joshua Birru
• Supervision – Dr. Varsha Shinde.
None Declared.
None.
We sincerely thank the patients and their families for their cooperation in this study. Their consent and support were invaluable to this work.