title: Severe paraquat poisoning: clinical and radiological findings in a survivor.
abstract: Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the therapeutic algorithm for severe paraquat poisoning.
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Universidade de São Paulo, Ribeirão Preto, SP, Brasil. fabioneves@hcrp.usp.br
authors.forename: Fábio Fernandes
authors.initials: FF
authors.lastname: Neves
authors.forename: Romualdo Barroso
authors.initials: RB
authors.lastname: Sousa
authors.forename: Antônio
authors.initials: A
authors.lastname: Pazin-Filho
authors.forename: Palmira
authors.initials: P
authors.lastname: Cupo
authors.forename: Jorge
authors.initials: J
authors.lastname: Elias Júnior
authors.forename: Marcello Henrique
authors.initials: MH
authors.lastname: Nogueira-Barbosa
mesh_terms: D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D010269:Paraquat / Q000506:poisoning*; D011041:Poisoning / Q000000981:diagnostic imaging; D011859:Radiography; D013406:Suicide, Attempted; D055815:Young Adult
chemical_list: D010269:Paraquat