End-stage pulmonary fibrosis following paraquat toxicity in a delayed presentation

Paraquat is a widely used herbicide in India. Although rare, its consumption for suicidal purposes is highly fatal due to the non-availability of an antidote. We report the case of an adolescent girl with a history of paraquat ingestion who presented 10 days later with respiratory distress and shock. She was managed with high-flow nasal oxygen, inotropes and antioxidants. High-resolution CT revealed extensive lung fibrosis, and she was recommended for evaluation for lung transplantation. This case highlights the progressive, irreversible pulmonary damage in delayed presentation of paraquat poisoning. The rarity of such presentations with visible pulmonary fibrosis progression underscores the need for better diagnostic and therapeutic guidelines and potentially aids ongoing research toward an effective antidote.