Survival of a patient after self-injection of paraquat and surgical excision of the injection site

Paraquat, a highly toxic bipyridyl compound, is widely used as a herbicide that causes serious morbidity and mortality when ingested. Death usually occurs within two days of ingestion of 50 mg/kg [1]. At lower doses death from pulmonary fibrosis is delayed for a few weeks as the toxic compound accumulates in lung tissue where free radicals are formed, lipid peroxidation is induced and nicotinamide adenine dinucleotide phosphate (NADPH) is depleted.The first case of fatal paraquat poisoning by subcutaneous injection was reported in 1967 [2]. Since then, a few more cases of parenteral paraquat poisoning have been reported. All were fatal. We report a patient with subcutaneous paraquat poisoning who survived following removal of the skin and subcutaneous tissue. Ceylon Medical Journal 2015; 60 : 66