title: Paraquat ingestion: a challenging diagnosis.
abstract: 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.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, DUMC Box 3046, Durham, NC 27710, USA. jerome.chen@duke.edu
authors.forename: Jerome G
authors.initials: JG
authors.lastname: Chen
authors.forename: David L
authors.initials: DL
authors.lastname: Eldridge
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Lodeserto
authors.forename: David Y
authors.initials: DY
authors.lastname: Ming
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Turner
authors.forename: Joel L
authors.initials: JL
authors.lastname: Vanderford
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sporn
authors.forename: Scott R
authors.initials: SR
authors.lastname: Schulman
mesh_terms: D055371:Acute Lung Injury / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D035641:Chest Wall Oscillation; D002648:Child; D018450:Disease Progression; D017809:Fatal Outcome; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced; D008168:Lung / Q000187:drug effects / Q000473:pathology; D008297:Male; D010269:Paraquat / Q000506:poisoning*; D011041:Poisoning / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D051437:Renal Insufficiency / Q000139:chemically induced; D012131:Respiratory Insufficiency / Q000139:chemically induced*
chemical_list: D006540:Herbicides; D010269:Paraquat