Paraquat Poisoning: A Fatal Issue in Rural West Bengal, India
Sujash Biswas, Abhishek Das, Nandini Das, Deepmalya Sengupta, Swarup Mondal, Biswajit Sukul
INTRODUCTION: Suicide takes away a significant number of lives every year in Indian society. Self-intake of poison is one of the most preferred methods in this regard. Paraquat, a frequently used herbicide with high fatality, has become a serious concern in West Bengal of late. CASE REPORT: H ere w e r eport a c ase r eport o f t hree c ases presented within an interval of 2 months. All the patients had been admitted after deliberate self-intake of paraquat. Two of these patients were of adolescent age group and one was an elderly male. Features of corrosion of lips, icterus, nausea, and respiratory distress were the presenting symptoms. Autopsy examination revealed definite lung, liver, kidney, and stomach pathology on macroscopy. Histopathological examination showed pulmonary congestion and edema. Features of hepatic sinusoidal dilatation and tubular necrosis were specifically found. All the organs showed polymorphonuclear (PMN) infiltrates under microscopy. DISCUSSION: Paraquat mostly gets concentrated in the lung, kidney, and liver and pathology is generated by reactive oxygen species-induced injury. No specific antidote is available till date and hemodialysis is of questionable use. Oxygen therapy even deteriorates the patient at times. So, conservative supportive management becomes the main scheme. Most of the patients expire as a result of pulmonary pathology. CONCLUSION: Early suspicion, enthusiastic decontamination approach, and prevention of further absorption can only save the patient. Here we attempted to present the comprehensive array of external and internal autopsy features with detailed histopathological findings.
Autopsy diagnosis, Histopathology, Paraquat poisoning, Pulmonary toxicity, Suicide.