Indian Journal of Respiratory Care

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VOLUME 12 , ISSUE 3 ( July-September, 2023 ) > List of Articles


A Rare Case of Inhalational Paraquat Lung Injury Leading to Progressive Pulmonary Fibrosis

N S Vishnu, Siddharth Tomar, Surabhi Jaggi, Saloni R Kumar, Mandeep K Sodhi

Keywords : Bilateral pneumothorax, Case report, Inhalational lung injury, Organizing pneumonia, Paraquat poisoning, Progressive pulmonary fibrosis

Citation Information : Vishnu NS, Tomar S, Jaggi S, Kumar SR, Sodhi MK. A Rare Case of Inhalational Paraquat Lung Injury Leading to Progressive Pulmonary Fibrosis. Indian J Respir Care 2023; 12 (3):266-271.

DOI: 10.5005/jp-journals-11010-1059

License: CC BY-NC-SA 4.0

Published Online: 30-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Poisoning with various synthetic chemicals used in farming is a public health problem of considerable importance worldwide, particularly in developing countries. One of them is paraquat (PQ), which is an extensively used synthetic, nonselective, contact herbicide in the Indian agriculture industry. Although fatalities due to accidental or suicidal oral ingestion of PQ are common, inhalational injury due to this poison is very rare and often difficult to diagnose without a proper specific history, since the presenting symptoms are usually nonspecific. Case presentation and progress: Here, we report a case of a 35-year-old male, who had an accidental inhalation of Paraquat that led to lung injury and further complications. Initially, the patient had mild flu-like respiratory symptoms, but later symptoms worsened and he progressed into pulmonary fibrosis within a span of 2–3 weeks. Treatment and outcome: The patient was admitted and managed in respiratory intensive care unit (ICU). He was managed with steroids, prophylactic antibiotic therapy, and other supportive measures. During the treatment course, he developed bilateral secondary spontaneous pneumothorax. Initially, he responded to the steroid pulse therapy, but later the pulmonary fibrosis progressed further and the patient succumbed after 1 month of ICU admission. Discussion and conclusion: Paraquat is a bipyridylium quaternary ammonium compound that will cause direct harm to the cellular structures by the production of various reactive oxygen species (ROS) and other free radicals. The lungs and kidneys are the most affected organs. The treatment of PQ intoxication is not well set out. Prompt supportive medical treatment is essential to minimize the damage and improve the chances of recovery.

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