PARAQUAT TONGUE: CASE OF PARAQUAT POISONING AND REVIEW OF LITERATURE

Abstract

We herein report a rare case of Paraquat poisoning which presented with multiple buccal mucosa and labial ulcers. He complained of burning pain in the mouth which increased on eating, along with difculty in complete mouth opening. The trismus progressed gradually from 4 ngers to 2 ngers breadth, over 2 days. The patient also had multiple episodes of vomiting with contents mainly being mucous secretions as the patient was nil per oral. Radiographic features including the imaging of the barium swallow of this case are discussed together with the pathomechanics of the poison. A comprehensive overview of the biochemistry and pharmacodynamics of Paraquat has been given as well. Understanding the mechanism of action of Paraquat will help to explain the manifestations of the poisoning and its subsequent treatment. Medical management was undertaken with the imperative step being the use of pulsatile steroid therapy. Supportive care and oral exercises were advised simultaneously to ensure optimum recovery. We looked at previously published literature to assess the proposed management protocols in the absence of a denitive antidote, leading to high mortality rates.