Death Due to Homicidal Paraquat Poisnong: A Case Report

Abstract

Background: Paraquat is a widely used herbicide that raises a significant public health concern due to its extreme toxicity even at low doses and its potential for criminal poisoning. However, most of the research is concentrated on pulmonary toxicity of the compound so far, ignoring its other systemic effects. Moreover, a perfect antidote for this poisoning remains still at large. Case Presentation: In this case report, we present probably the first case of criminal paraquat poisoning in India, involving a 40-year-old man who was poisoned by family members with paraquat-laced alcohol. Although the patient initially appeared to be recovering, his condition worsened, and he died from multi-organ dysfunction syndrome (MODS). Discussion: Paraquat poisoning presents with a spectrum of clinical features, mainly affecting the lungs and kidneys, often leading to respiratory and renal failure. However, its toxicity extends to other organs like liver causing toxic hepatitis that prompts us for a proper diagnosis and management. Current research and management protocols tend to neglect the hepatic and renal toxicities, focusing primarily on pulmonary fibrosis. The manufacture and sale of paraquat in India needs to be reviewed in the light of increasing global bans of this compound. There is also a pressing need for antidote research in dealing with agrochemical substance abuse, particularly paraquat. Conclusion: The emergence of paraquat as a lethal homicidal poison highlights the need for stringent regulations and proactive measures to safeguard public health. The whole saga of chemical/pesticide regulation in our country is very naïve when compared to the global standard. It is time to foster collaboration between regulatory bodies, healthcare professionals, and researchers to address the menace of ‘paraquat deaths’ in India.

Keywords

• paraquat
• criminal poisoning
• homicide
• herbicide
• dithionate test
• forensic toxicology