Paraquat toxicity

Background

Paraquat is an herbicide that has a rapid and large distribution and can be fatal even with small ingestions. It has a high case-fatality rate (>50%) which makes it a frequent means of suicide in the developing world, as well as a dangerous accidental occupational exposure.

Clinical Features

Paraquat Tongue (Credit: wikitox.org)

• Gastrointestinal: predominate early
  • Paraquat tongue
  • Esophageal and gastric erosion
  • Nausea and vomiting
• Pulmonary: occurs due to distribution to pneumocytes
  • Pneumonitis
  • Pulmonary fibrosis (delayed)
• Multiorgan failure
  • Acute renal failure
  • Hepatic necrosis
  • Myocardial necrosis
  • Internal bleeding