Rare fatal poisoning through dermal exposure to paraquat

Paraquat skin contact occurs less frequently and is rarely fatal. This article reports a case of a 45-year-old man who presented with dysphagia, respiratory distress and grade two, and third skin burns focusing on the upper body after accidental exposure to paraquat. He was admitted to the hospital 6 days after the first contact. The urine sodium dithionate test was strongly positive. The O₂ saturation at admission was 52%, which reached 91% with a bag valve mask. Rising blood liver enzymes, urea, creatinine, and respiratory acidosis in the venous blood gas analysis were observed in the lab data. In the course of hospitalization, the patient was intubated due to oxygen level dropping. Evidence of acute respiratory distress syndrome and decreased level of consciousness was also observed. However, despite treatment with corticosteroids, antioxidants, and hemodialysis, he died on the fourth day of hospitalization. It is concluded that dermal exposure with paraquat could be life-threatening if the patient presented late with organ involvement.