A 16-year-old boy with rapidly progressing pulmonary fibrosis

Sequential Radiologic and Functional Pulmonary Changes in Patients with Paraquat Intoxication

The sequential changes of paraquat-induced pulmonary damage were studied using high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) in long-term follow-up. Among the cohort of 27 patients who had ingested paraquat, the HRCT findings showed a normal (n = 14) and an abnormal group (n = 13). Increased paraquat ingestion in the abnormal group was associated with more rapid and severe pulmonary changes. Ground-glass opacity on HRCT peaked on day 7 after ingestion. Between 2 weeks and 1 month, consolidation increased and pulmonary fibrosis progressed, and slow improvements were observed for up to six months. Compared with the PFT results obtained at 1 and 6.5 months, FVC, FEV1, and diffusing capacity all improved slightly. Lung changes after paraquat intoxication are functionally and radiologically reversible following treatment.

Paraquat ingestion: a challenging diagnosis

Paraquat is an herbicide that is highly toxic to humans. Pediatric ingestion has become uncommon in the United States because of preventative efforts. We report here an unintentional, fatal paraquat ingestion by an 8-year-old child. Storage in an inappropriate container, confusion between herbicide trade names, nonspecific symptoms, and a delay in follow-up produced challenges in the diagnosis. In the absence of a clear history of ingestion, paraquat poisoning should be suspected in children who develop skin and mucous membrane burns, gastrointestinal symptoms, acute kidney injury, and respiratory failure.