Diagnostic correction based on toxicology: A case of combined dichlorvos ( <scp>DDVP</scp> ), ethanol, and pesticide co‐solvent intoxication

Organophosphate pesticides (OPs) are commonly encountered toxic substances in poisoning incidents, often associated with severe clinical symptoms. The diagnosis and treatment become more complicated, especially when mixed with other toxic substances, requiring detailed toxicological analysis to identify the involved agents. This report presents a case of mixed poisoning in a 37-year-old male who ingested 250 mL of 40% alcohol and was admitted with impaired consciousness, absent pupillary light reflexes, and severe metabolic acidosis, which did not improve with initial treatment. Gas chromatography and gas chromatography-mass spectrometry analysis of the collected samples revealed dichlorvos (DDVP) in the gastric contents, along with 2,2-dichloroethanol, ethanol, butyl acetate, and isobutyl acetate in the blood. Following accurate diagnosis and targeted treatment, the patient's condition gradually improved. This case highlighted the critical role of toxicological testing in diagnosing complex poisoning, providing vital guidance for clinical management, and emphasizing the importance of collaboration between laboratory and clinical teams in the treatment of acute poisoning.