Homicidal paraquat poisoning: Poisoned while drinking

Abstract

The incidence of paraquat poisoning has significantly decreased with the addition of odorizer and emetics to the liquid concentrate. Paraquat poisonings are usually attributed to suicidal and accidental or occupational exposure. Here, we report an unusual fatal case of homicidal paraquat poisoning. An intoxicated, a 37‐year‐old man consumed a mixture of white wine and paraquat prepared by his wife. This resulted in intermittent vomiting, which he attributed to being intoxicated. The man was admitted to the hospital for treatment 3 days later. Due to the lack of knowledge of paraquat exposure, the man did not receive effective treatment and died of respiratory failure 22 days later. High‐performance liquid chromatography‐tandem mass spectrometry (HPLC‐MS/MS) was applied to detect paraquat in 16 postmortem specimens: kidney (1.31 ug/g), urine (0.91 ug/ml), liver (0.62 ug/g), lung (0.39 ug/g), muscle (0.35 ug/g), bile (0.32 ug/ml), heart (0.28 ug/g), brain (0.22 ug/g), pancreas (0.22 ug/g), spleen (0.18 ug/g), cardiac blood (0.15 ug/ml), cerebrospinal fluid (0.14 ug/ml), pericardial effusion (0.12 ug/ml), pleural effusion (0.09 ug/ml), peripheral blood (0.08 ug/ml), and vitreous humor (0.06 ug/ml). The highest concentration of paraquat was detected in the kidney followed by the urine in all tissues and body fluids. At present, although the cases of paraquat poisoning have decreased, the high mortality rate resulting from its irreversible lung damage and respiratory failure makes paraquat poisoning, especially occult paraquat poisoning, still needs to be carefully identified in forensic practice and clinical diagnosis.

Construction of prognosis prediction model and visualization system of acute paraquat poisoning based on improved machine learning model

“…Studies on the mechanism of paraquat poisoning and damage have revealed that oxidative stress, such as the generation of reactive oxygen species (ROS) and other immune stimulatory effects released in large quantities, is associated with paraquat poisoning and damage, leading to tissue damage and intracellular calcium overload [8][9][10]. Many researchers have studied the early lesions of paraquat poisoning and have determined that early diagnosis and treatment are key factors in saving patients with paraquat poisoning [11][12][13]. The eld of medicine has witnessed the emergence of machine learning, an arti cial intelligence algorithm that has gained prominence in recent years.…”

Intoxicação com aldicarb "chumbinho": aspectos epidemiológicos, clínicos, terapêuticos, preventivos e educativos

“…As intoxicações exógenas no Brasil são um problema de saúde pública, levando muitos pacientes à morte e geralmente são atribuídas a exposições suicidas, acidentais ou ocupacionais (XAVIER et al, 2007;LIU et al, 2022).…”

A Forensic Case of Suicide Ingestion of Paraquat Herbicide

“…International literature attributes 14% to 20% of total suicides to agricultural pesticide poisoning, 1 making them one of the main contributors to the global suicide burden 2 . Among all agricultural pesticides, Paraquat (PQ) is one of the most widely used herbicides in the world, and poisoning is generally associated with accidental events, 3,4 suicides, 5–7 or homicides 8–13 . Accidental occurrences 14,15 are usually detectable a few hours after exposure and occur mainly among agricultural operators.…”

“…2 Among all agricultural pesticides, Paraquat (PQ) is one of the most widely used herbicides in the world, and poisoning is generally associated with accidental events, 3,4 suicides, [5][6][7] or homicides. [8][9][10][11][12][13] Accidental occurrences 14,15 are usually detectable a few hours after exposure and occur mainly among agricultural operators. They are due to noncompliance with the precautions of use of PQ or negligence in its custody or handling.…”

“…Literature also describes some rare cases of parenteral injections of PQ for suicide purposes. 5,17,18 Homicidal PQ poisonings are rare, generally occult, 13 and initially very difficult to diagnose, especially if exposure is not clearly denotable or symptoms are mild and nonspecific. This may lead to a diagnostic delay due to nonrecognition of poisoning and the implementation of nonspecific procedures as recommended by both guidelines and good clinical practices.…”