A Case of Paraquat Poisoning Presenting With Spontaneous Pneumothorax and Pneumomediastinum

Lung transplantation in a woman with paraquat poisoning that led to pulmonary fibrosis-Widely reported by the media: A case report

RATIONALE

Paraquat is an extremely toxic herbicide with a high mortality rate on poisoning. It can damage vital organs, such as the lungs, liver, heart, and kidneys. In this study, we report a case of pulmonary fibrosis after paraquat poisoning in a patient who underwent a lung transplant procedure after preoperative administration of corticosteroids and immunosuppressive agents and continuous noninvasive ventilation support therapy.

PATIENT CONCERNS

An 18-year-old student was hospitalized owing to diarrhea, chest pain, and gradually evolving dyspnea.

DIAGNOSES

Owing to the inability to estimate the intake concentration and dose, paraquat was only detected in the urine on the 13th day, resulting in rapid progression of the disease and severe pulmonary fibrosis.

INTERVENTIONS

Extensive media coverage has attracted the attention of all sectors of society. The patient received financial assistance; thus, she could receive a double-lung transplant with extracorporeal membrane oxygenation (ECMO) support on the 34th day after the poisoning.

OUTCOMES

Postoperatively, the girl was actively rehabilitated, adhered to anti-rejection medication, followed up regularly, and had a good prognosis.

LESSONS

Lung transplantation is currently the most effective treatment for pulmonary fibrosis, and mass media campaigns can provide economic support, influence potential organ donation, and provide such patients more chances to survive.

Pneumothorax and Pneumomediastinum Complicating Organophosphate Poisoning: A Case Series of Complications Less Understood

Organophosphate compounds are used as insecticides in agricultural and domestic settings throughout the world. Acute organophosphorus (OP) poisoning is a major public health issue. Early diagnosis of OP poisoning and prompt atropinization can save lives. Respiratory failure may occur in patients with OP poisoning for many reasons, including aspiration of gastric contents, excessive secretions, pneumonia, and sepsis complicating acute respiratory distress syndrome. Till date, however, spontaneous pneumothorax and pneumomediastinum have not been reported in cases of OP poisoning. This report presents two similar cases of OP poisoning in which spontaneous pneumothorax and pneumomediastinum developed following OP ingestion.

Paraquat Poisoning Associated With Daisley Barton Syndrome: A Case Report

Pesticides include insecticides, herbicides, and rodenticides. Pesticide poisoning can be intentional, accidental, or occupational. Around 385 million cases of unintentional acute pesticide poisoning occur annually worldwide, with approximately 11,000 fatalities. Herbicides are used to kill weeds and can include chlorophenoxy compounds, bipyridyls, urea-substituted herbicides, organophosphates, and glyphosate. Paraquat is a bipyridyl nonselective contact herbicide with high mortality rates upon exposure in humans. Paraquat poisoning causes acute lung injury, rarely leading to pneumothorax and pneumomediastinum, referred to as Daisley Barton Syndrome. We report a case of a 22-year-old female from Uttarakhand, India, who accidentally ingested paraquat. She was initially asymptomatic, but later developed lung, liver, and kidney injuries as well as pneumomediastinum and pneumothorax.