Paraquat poisoning: Acute lung injury – a missed diagnosis
Paraquat is a herbicide of great toxicological importance because it is associated with high mortality rates, mainly due to respiratory failure. We report the case of a 28-year-old man admitted to the casualty department at Ngwelezana Hospital, Empangeni, KwaZulu-Natal, South Africa, with a history...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2017-05-01
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| Series: | South African Medical Journal |
| Subjects: | |
| Online Access: | http://www.samj.org.za/index.php/samj/article/view/11890/8052 |
| _version_ | 1797368251034894336 |
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| author | Sipho D Ntshalintshali Thandekile C Manzini |
| author_facet | Sipho D Ntshalintshali Thandekile C Manzini |
| author_sort | Sipho D Ntshalintshali |
| collection | DOAJ |
| description | Paraquat is a herbicide of great toxicological importance because it is associated with high mortality rates, mainly due to respiratory failure. We report the case of a 28-year-old man admitted to the casualty department at Ngwelezana Hospital, Empangeni, KwaZulu-Natal, South Africa, with a history of vomiting and abdominal pain after ingestion of ~100 mL of an unknown substance, later identified as paraquat, together with an unknown amount of alcohol, in a suicide attempt. He developed respiratory distress associated with lung parenchymal infiltrates that required ventilatory support and later a spontaneous pneumothorax, and died in the intensive care unit. We discuss the importance of a high index of suspicion of paraquat poisoning in rural areas, where paraquat is readily available as a herbicide on farms, in patients with a similar presentation. We further stress the importance of identifying the classic radiological progression after paraquat poisoning, to help avoid a delay in diagnosis if the culprit substance is not known (as happened in our case). Lastly, we look at the importance of avoiding oxygen supplementation, and early administration of immunosuppressive therapy, to improve outcome. |
| first_indexed | 2024-03-08T17:29:59Z |
| format | Article |
| id | doaj.art-a7a83ea563f14baf979ed19f8df39d46 |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T17:29:59Z |
| publishDate | 2017-05-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-a7a83ea563f14baf979ed19f8df39d462024-01-02T16:39:03ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352017-05-01107539940110.7196/SAMJ.2017.v107i5.12306Paraquat poisoning: Acute lung injury – a missed diagnosisSipho D Ntshalintshali0Thandekile C Manzini1Department of Internal Medicine, Ngwelezana Hospital, Empangeni, KwaZulu-Natal, South AfricaDepartment of Internal Medicine, Ngwelezana Hospital, Empangeni, KwaZulu-Natal, South AfricaParaquat is a herbicide of great toxicological importance because it is associated with high mortality rates, mainly due to respiratory failure. We report the case of a 28-year-old man admitted to the casualty department at Ngwelezana Hospital, Empangeni, KwaZulu-Natal, South Africa, with a history of vomiting and abdominal pain after ingestion of ~100 mL of an unknown substance, later identified as paraquat, together with an unknown amount of alcohol, in a suicide attempt. He developed respiratory distress associated with lung parenchymal infiltrates that required ventilatory support and later a spontaneous pneumothorax, and died in the intensive care unit. We discuss the importance of a high index of suspicion of paraquat poisoning in rural areas, where paraquat is readily available as a herbicide on farms, in patients with a similar presentation. We further stress the importance of identifying the classic radiological progression after paraquat poisoning, to help avoid a delay in diagnosis if the culprit substance is not known (as happened in our case). Lastly, we look at the importance of avoiding oxygen supplementation, and early administration of immunosuppressive therapy, to improve outcome.http://www.samj.org.za/index.php/samj/article/view/11890/8052Radiological progressionLung injuryParaquat toxicity |
| spellingShingle | Sipho D Ntshalintshali Thandekile C Manzini Paraquat poisoning: Acute lung injury – a missed diagnosis South African Medical Journal Radiological progression Lung injury Paraquat toxicity |
| title | Paraquat poisoning: Acute lung injury – a missed diagnosis |
| title_full | Paraquat poisoning: Acute lung injury – a missed diagnosis |
| title_fullStr | Paraquat poisoning: Acute lung injury – a missed diagnosis |
| title_full_unstemmed | Paraquat poisoning: Acute lung injury – a missed diagnosis |
| title_short | Paraquat poisoning: Acute lung injury – a missed diagnosis |
| title_sort | paraquat poisoning acute lung injury a missed diagnosis |
| topic | Radiological progression Lung injury Paraquat toxicity |
| url | http://www.samj.org.za/index.php/samj/article/view/11890/8052 |
| work_keys_str_mv | AT siphodntshalintshali paraquatpoisoningacutelunginjuryamisseddiagnosis AT thandekilecmanzini paraquatpoisoningacutelunginjuryamisseddiagnosis |