Paraquat poisoning.

Poisoning by pesticides and other agricultural chemicals is a major public health problem worldwide, especially in developing countries. Globally, there are about 20,000 annual fatalities and more than 2 million hospitalizations due to poisoning by pesticides and agricultural chemicals.1 There were approximately 340,000 cases of agricultural and horticultural poisoning reported in the United States during 1985 through 1990, with 97 deaths. Paraquat poisoning accounted for only 0.34% of those cases, but paraquat poisoning had the highest mortality rate, accounting for 13% of all fatal cases.2 Severe paraquat poisoning is characterized by multiple-organ failure, involving mainly the lungs, kidneys, and liver. The lung is a major target organ in paraquat poisoning, and respiratory failure from lung injury is the most common cause of death. It is important to make an early diagnosis and to start appropriate treatment as soon as possible. This article presents a case of fulminant paraquat poisoning and discusses the pathophysiology and management of paraquat poisoning.