Clinical presentation and outcomes of Intentional Paraquat Ingestion in a hospital at Northern Philippines from 2011 to 2013
- Author:
Jose Carlo B. Valencia
1
;
Paul Francis Pua
1
Author Information
- Publication Type:Case Reports
- Keywords: Case report
- MeSH: Paraquat; Herbicides; Eating; Poisoning
- From: Philippine Journal of Internal Medicine 2018;56(4):258-263
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Acute paraquat (PQ) poisoning is associated with high case fatality rate. Following a report of 108 cases of poisoning from 2011 to 2013, the distribution, sale, and use of PQ was recently prohibited in the Philippines. However, there still is a need to gather additional information on the manifestations of PQ poisoning in the Philippines. Hence, this study aimed to identify the clinical presentation and outcomes of cases of PQ poisoning seen in a hospital at northern Philippines.
Case presentation:Nine cases of oral PQ poisoning from 2011 to 2013 were included in this series. All cases were intentional. Majority (88%) of the patients were females. Seven of the nine (77%) cases were from Baggao, Cagayan, a nearby agricultural town. Mean age was 30 (range 21-47). Initial presenting symptoms were vomiting, difficulty in swallowing, abdominal pain and gastrointestinal bleeding. Of the nine cases, four died (44%) in the hospital. Three (33%) survived without complications. Long-term outcomes of the remaining two cases (22%) were unknown. All patients who eventually died developed dyspnea during their hospital stay, and subsequently went into acute respiratory failure. Azotemia and leukocytosis were also recorded among those who died.
Discussion:High mortality rate among PQ poisoning patients can be attributed to the absence of antidote and the unsatisfactory outcomes of post-exposure management.
Conclusion:Mortality rate for this series was 44%, and all died of progressive respiratory failure. Gastrointestinal toxicity was universal in the nine reported cases. Azotemia and leukocytosis were the other significant findings observed among the cases of fatal poisoning - Full text:Clinical-presentation.pdf
