Paraquat poisoning: A case report

According to world health organization (WHO), paraquat is categorized as moderately hazardous, but its ingestion is associated with high toxicity and mortality and there is no specific antidote for paraquat poisoning.

Case report:

 A 75-year-old female was admitted to the emergency room with an alleged history of ingestion of 1 glass of paraquat (liquid form). Examination of oral cavity showed tongue and mucosal erosion. Cardiovascular, chest, and CNS examinations were normal. Gastric lavage was performed and she received IV fluids and an antiemetic as a supportive measure. Intravenous steroids and N-Acetylcysteine and proton pump inhibitors were added to the treatment. Input/output charting and vital monitoring was done. Her initial chest X ray, ECG, and abdominal ultrasonography were normal. Initially, her CBC, Electrolytes, liver function tests, and kidney function tests were within the normal ranges. During the hospital stay, blood creatinine increased to 2.2 mg% and kidney function tests deteriorated gradually. The patient developed AKI and was supported with haemodialysis. Patient's condition improved over period of time, she started accepting orally and urine output was adequate. She was then discharged with stable vital signs and was asked to follow-up in the outpatient department. Early diagnosis, aggressive decontamination and supportive care should be established in paraquat poisoning.

Since there is no known antidote for it, further absorption must be prevented in order to manage paraquat poisoning successfully.