Paraquat Poisoning Presenting as the “Daisley Barton Syndrome”

Chaudhuri, Souvik; Sagar, Maddani Shanmukhappa; Ravindranath, Sunil; Reddy, V. Diwakar

doi:10.4103/ijrc.ijrc_47_19

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Severe poisoning can lead to multiple organ failure, including pulmonary edema or fibrosis, liver failure, renal failure, cardiotoxicity, leading to high mortality. Chaudhuri et al 16 reported a fatal case of paraquat poisoning complicated with bilateral spontaneous pneumothorax secondary to lung injury, also called the “Daisley Barton Syndrome”. Adejumo et al 17 reported a case of paraquat poisoning complicated with delayed AKI, which indicating of the importance of monitoring renal function.…”

Section: Discussionmentioning

confidence: 99%

Esophagitis dissecans superficialis associated with acute transoral paraquat poisoning: Clinical study of 15 cases

Tao

Guo

et al. 2021

Science Progress

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To analyze the clinical characteristics and therapeutic effects of transoral paraquat poisoning combined with Esophagitis dissecans superficialis (EDS). A retrospective observational study was conducted on paraquat poisoning patients between January 1, 2011 and August 30, 2016 in Qilu hospital. Fifteen patients with EDS were enrolled in this study. The clinical characteristics, prognosis, and pathological features of esophageal necrosis mucosa of these patients were retrospectively analyzed and summarized. Esophageal mucosal dissection occurs mainly within 3–8 days after transoral paraquat poisoning in 15 patients. Dosage of paraquat is range from 50 to 100 ml. Most patients have physical problems with swallowing before the intramural esophageal dissection occurred. And there are other symptoms, including sore throat or dysphagia (100%), nausea and vomiting (86.7%), heartburn or upper abdominal pain (73.3%), hematemesis (60%), abdominal distension (20%) and cough frequently (6.7%). In death group, most patients demonstrate features of the multiple organ failure when the esophageal mucosal stripping happened, including lung injury, renal failure, and hepatic failure. The shape of esophageal dissection was tubular in 60%, irregular in 40%, and they vary in size. Pathological examination showed extensive injury, necrosis and hemorrhage of digestive tract epithelium, and obvious inflammatory reaction of epithelial tissue. Transoral paraquat poisoning has certain damage to the patient’s esophageal mucosa, and some may be complicated with EDS, and the prognosis is poor, especially when combined with multiple organ dysfunction. Esophageal damage is mainly located in the esophageal mucosa and have different degrees. Special attention should be paid on such patients.

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Section: Discussionmentioning

confidence: 99%

Esophagitis dissecans superficialis associated with acute transoral paraquat poisoning: Clinical study of 15 cases

Tao

Guo

et al. 2021

Science Progress

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Fulminant Paraquat Poisoning Leading to Spontaneous Pneumomediastinum: A Rare but Catastrophic Complication

Aggarwal

Lamba

Gaba

et al. 2022

APIK Journal of Internal Medicine

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Paraquat (PQ) is a liquid herbicide commercially traded under the name “Gramoxone.” Human ingestion is uncommon but often fatal. Toxicity of PQ is mediated by the generation of reactive oxygen species which damages cell membranes. Apart from local corrosive damage to the gastrointestinal system, the lungs, liver, and kidneys bear the maximum damage. Rarely, PQ may present as spontaneous pneumothorax or pneumomediastinum or both. Herein, we present a case of fatal PQ poisoning where the patient developed pneumomediastinum on the 9th day with multiorgan dysfunction leading to his demise on 12th day. We also take this opportunity to briefly describe the pathogenesis of lung toxicity, the clinical manifestations, and various treatment strategies being explored in the different parts of the world, as no specific antidote is available till date.

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Isolated Spontaneous Pneumomediastinum Associated with Paraquat Poisoning: A Case Report

Fotedar,

Shiv,

Bhatti

2024

The Indian Journal of Chest Diseases and Allied Sciences

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Paraquat bipyridal herbicide, accidental and suicidal ingestion of the compound is associated with fatal toxicity. The corrosive nature of paraquat results in local effects including oral, esophageal, and gastric ulceration with esophageal rupture at times. Oxygen reactive species generation results in systemic manifestations characterized by MODS, acute liver and kidney injury, metabolic acidosis, acute respiratory distress syndrome, and pulmonary fibrosis. Spontaneous pneumothorax (Daisley Barton syndrome) with or without associated pneumomediastinum and subcutaneous emphysema has been reported with this poisoning and represents poor prognostic markers. An adult male was referred to our Institute for Management of MODS with impending respiratory failure with a history of paraquat ingestion, contrast-enhanced computed tomography (CECT) thorax revealed Pneumomediastinum with bilateral pulmonary infiltrates. The patient was managed accordingly and continuous renal replacement therapy (CRRT) was planned for acute renal shut-down, patient expired on the next day of admission. Isolated pneumomediastinum without subcutaneous emphysema and pneumothorax is an uncommon presentation associated with paraquat poisoning. Authors report a case of pneumomediastinum associated with paraquat poisoning with the aim to stress on pulmonary complications associated with paraquat. It is recommended that in patients with unrecognizable etiology of pneumomediastinum with or without pneumothorax, paraquat poisoning should be kept as one of differential diagnosis.

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Paraquat Poisoning Presenting as the “Daisley Barton Syndrome”

Cited by 4 publications

References 10 publications

Esophagitis dissecans superficialis associated with acute transoral paraquat poisoning: Clinical study of 15 cases

Esophagitis dissecans superficialis associated with acute transoral paraquat poisoning: Clinical study of 15 cases

Fulminant Paraquat Poisoning Leading to Spontaneous Pneumomediastinum: A Rare but Catastrophic Complication

Isolated Spontaneous Pneumomediastinum Associated with Paraquat Poisoning: A Case Report

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