Causes and risk factors
Breathing in paraquat, accidental consuming of paraquat, skin contact with paraquat can lead to the toxic condition. Though paraquat is poorly absorbed. Peak plasma concentration of the substance occurs within an hour after ingestion; however, more concentrates accumulate in lungs than plasma. The distributions occur rapidly within the cells, i.e., pneumocytes. Paraquat is excreted through the renal route. Consumption or exposure to paraquat have a poor prognosis with high morbidity and mortality rate.
Clinical presentation
Patient presents with sore throat, burning in throat. There is shortness of breath, difficulty in breathing. Nosebleed can occur. Stomach pain, vomiting may occur. Seizures can occur. Patient may end up in shock or even coma. Multiorgan failure can occur such as acute renal failure, hepatic necrosis, myocardial necrosis, pulmonary fibrosis, acute pneumonitis, or internal hemorrhages.
Investigations
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Blood test is required. Arterial blood gases are recommended. Urine analysis is done. Urine toxicological screening is advised. Paraquat assay is advised. Sodium dithionite test in urine is specific for paraquat poisoning.
Treatment
There is no specific treatment. Removing all contaminated clothing is necessary. Symptomatic treatment is given. Reducing the toxicity by washing, eye wash, vomiting, etc., is helpful. Activated charcoal is used for early gastric lavage. Maintenance of oxygen levels and ventilation is taken care of. Plasma exchange and hemofiltration is done in severe cases.
Complications
Complications such as acute respiratory distress syndrome, holes in the esophagus, kidney failure may occur.
When to Contact a Doctor
One must consult a doctor if one comes in contact with such herbicide.
Prevention
Avoiding exposure to paraquat, wearing protective clothing, nose masks can prevent the disease.
Systems involved
Circulatory system, respiratory system, GIT, CNS
Organs involved
Nose, throat, lungs, stomach, liver, kidneys, blood vessels, brain
