A 3-year-old girl with drooling, rhinorrhea, bronchorrhea, and wheezing after exposure in a garage most likely has poisoning with what?

• A. Organophosphate
• B. Methanol
• C. Ethanol
• D. Carbon monoxide

Answer: (A)

Organophosphate poisoning occurs when acetylcholinesterase is inhibited, causing an excess of acetylcholine at muscarinic receptors. That leads to secretions and bronchial effects: drooling, rhinorrhea, bronchorrhea, and bronchospasm with wheezing. A garage exposure fits because organophosphates are common pesticides used in that setting. The combination of increased secretions and wheezing is a classic muscarinic overdrive pattern from acetylcholinesterase inhibition. By contrast, methanol or ethanol mainly cause metabolic/central nervous system effects, and carbon monoxide presents with headache, confusion, or hypoxia-related symptoms rather than profuse bronchial secretions and wheezing. This makes organophosphate poisoning the best explanation.