病患為 62 歲之男性,因自殺而入院,在急診期間因呼吸衰竭而進行氣管插管並送至加護病房作進一步治療。於急診病患意識不清、針狀瞳孔且痰液分泌量多、但並無發燒或心跳過慢之情形,乙醯膽鹼脂 (Cholinesterase)檢驗值 154 IU/L。初期診斷為有機磷中毒伴有呼吸衰竭。對於有機磷中毒給予 Atropine 及 Pralidoxime 治療,72 小時後病患意識已轉清醒,瞳孔縮小改善且呼吸道分泌物量漸為減少,已沒有腹瀉之情形,但乙醯膽鹼脂持續下降至 21 IU/L,其後生命跡象穩定並開始嘗試脫離呼吸器。
        中毒後第 5 天病情再度惡化無法順利脫離呼吸器,病患再次出現針狀瞳孔、嚴重腹瀉、唾液及痰液等分泌物大量增加,並伴有心跳緩慢之情形,呼吸肌力下降,四肢及頸部肌肉無力且無反射,乙醯膽鹼脂 持續被抑制,約為 28 IU/L。故此被診斷為有機磷中毒造成持續性肌肉收縮導致之中間期症候群 (Intermediatesyndrome)。而在中間期症候群期間,主要採取症狀療法,病患因大量腹瀉,而需補充水份及校正電解質,並延長 atropine 之使用期,同時維持呼吸器治療。在中毒後第 14 天,最大吸氣壓(PImax)及吐氣壓(PEmax)增加,呼吸肌強度雖增加但仍無法脫離呼吸器,測得乙醯膽鹼脂 值為 21 IU/L。而在四肢無力、唾液量多、腹瀉、心跳緩慢等症狀已然改善後,終於在第 22 天成功脫離呼吸器,並轉至普通病房。

    The patient is a sixty-two years old male, who was admitted to the hospital due to suicide. During the emergency treatment, he had undergone intubation in the endotrachea because of respiratory failure. The patient was no conscious, had pin-point pupil and massive amount of sputum. However, he had no fever or bradycardia. Cholinesterase was 154 IU/L under emergency treatment. Organophosphate intoxication and respiratory failure are observed in initial diagnosis. 
    Atropine and Pralidoxime were given to treat organophosphate intoxication. The patient was conscious clear after 72 hours. His pin-point pupil improved, secretions from the respiratory tract was much less and there was no diarrhea. Yet, cholinesterase continued to drop to 21 IU/L. His condition was stable and had begun to wean from the respiratory ventilator. 
    On the fifth day after intoxication, his condition became worse again and was unable to wean from the respiratory ventilator. Pin-point pupil reoccurred. There was serious diarrhea, great increased of secretions and saliva together with bradycardia. His breathing thew dropped. There was no reflection in the limbs and neck muscles and they felt weak. Cholinesterase was being suppressed to about 28 IU/L. Organophosphate intoxication has led to continuous muscle contraction. This is diagnosed as intermediate syndrome. Symptom treatment and supportive care was the first choose during intermediate syndrome. The patient had serious diarrhea and was supplied with water and maintain electrolyte balance. The use of atropine was prolonged and the respiratory was being maintained. On the fourteenth day after intoxication, Pimax and Pemax increased. The respiration muscle though became stronger, but was still unable to wean from the respiratory ventilator. The cholinesterase was examined to be 21 IU/L. After improvements from symptoms like impotent limbs, massive saliva, diarrhea, bradycardia, the patient was finally wean from the respiratory ventilator and being sent to ordinary ward on the twenty-second day.