A male farmer aged 36 years presented to to casualty with fits, vomiting, diarrhoea, incontinence of urine and altered sensorium following consumption of OP compound and diesel 3 hours earlier. Patient was drowsy, unresponsive (GCS 5/15), vitals-within normal limits, SpO2 84%, breath smelt of OP compound and he had miosis. Generalised tonic clonic seizures were observed and patient was areflexic with extensor plantars. Crepitations were heard over bilateral bases. Cardiovascular and Abdominal examination was normal. LAB = ABG analysis showed metabolic acidosis (pH 7.28, pCO2 27.6, HCO3- 12.7 with a base excess of -12.8) complete blood picture showed normocytic normochromic blood picture with leucocytosis ( Hb- 16.9 g%, WBC- 11830/ cu. mm, Platelets- 3,13,000/ cu.mm), and Pseudocholinesterase levels were <200 U/L. Liver function tests, renal function tests, serum electrolytes, urine analysis, Plain CT Brain,Chest XRay and ECG were normal.

Based on history, presenting features, clinical signs and lab + radiologocal findings, a diagnosis of OP Compound + Diesel poisoning with Status Epilepticus, Lipoid/ Aspiration Pneumonia B/L lower lobes, and Type 1 Respiratory Failure was made.