Paraquat Poisoning: Stories of Narrow Escape

Paraquat is a highly toxic non-selective herbicide widely used in agricultural practice across the world. Accidental or more commonly suicidal ingestion is prevalent in our part of the world as it is freely available and inexpensive. Around 8-10 cases are treated in our hospital every year as it serves as a tertiary care center for a large farming population in the neighboring hilly areas. The case fatality is extremely high even in centers practicing aggressive management including extracorporeal elimination and immunosuppression. The mortality varies from 50% to 90% but in cases with ingestion of concentrated solution mortality is 100%. 1 As the lethal dose is very low, survival after intoxication is very rare. Here we present two cases of paraquat poisoning with features of systemic toxicity and organ damage but who had complete recovery with supportive care.