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Homicidal paraquat poisoning: Poisoned while drinking.
Zihao Liu1, Fang Huang1, Shuquan Zhao1
1Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Journal of Forensic Sciences
|January 10, 2022
Summary
This case report details a rare homicidal paraquat poisoning. Despite decreased incidence, paraquat
Area of Science:
- Forensic Toxicology
- Clinical Chemistry
- Environmental Health
Background:
- Paraquat poisoning incidence has decreased due to safety measures like odorizers and emetics.
- Historically, paraquat poisonings result from suicide, accidental, or occupational exposures.
- This study focuses on an atypical fatal case of homicidal paraquat poisoning.
Observation:
- A 37-year-old man ingested paraquat mixed with wine, administered by his wife.
- Initial symptoms of vomiting were attributed to intoxication, delaying diagnosis and treatment.
- The patient died 22 days later from respiratory failure due to delayed and ineffective treatment.
Findings:
- High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) detected paraquat in 16 postmortem specimens.
- The highest paraquat concentrations were found in kidney (1.31 ug/g) and urine (0.91 ug/ml).
- Significant paraquat levels were also measured in liver, lung, and various other tissues and body fluids.
Implications:
- Paraquat poisoning, particularly occult cases, requires careful identification in forensic and clinical settings due to its high mortality.
- Irreversible lung damage and respiratory failure remain critical concerns.
- This case underscores the importance of considering homicide in paraquat poisoning investigations.