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Revision of the algorithm of the combined treatment in an intoxicated patient by paraquat in the hospital docente ambato-Ecuador

Abstract:

Paraquat is a potent herbicide used in agriculture. Intoxication in humans is produced by oral ingestion, accidental or for suicidal purposes. It has a severe poisoning; its mortality is high, more frequent in males. A case study is presented a 16-year-old patient, who voluntarily ingests the unknown substance, compatible with herbicide, after a problem with a family member. He presented odynophagia and green vomit. The patient went to the emer- gency service 4 hours after of intake. At the hospital, the patient was received conscious, stable vital signs and oropharynx erythematosus, gastric lavage and administration of activated charcoal for an occasion. However, the patient remained in observation for 12 hours and was discharged; in the next 24 hours he comes for dysphagia for solids and heartburn, the physical examination showed whitish lesions in the retropharynx. Complementary tests showed alterations of renal function and positive dithionite test (PARAQUAT), so he is admitted. During the first days of hospitalization, the patient showed progressive deterioration of renal function and mild hepatic involvement, which normalizes after the fourth day, after combined management plus adequate hydration. After 13 days of hospitalization, the patient is discharged, asymptomatic with follow-up by external consultation to assess possible complications. The patient received the appropriate treatment between 24-48 hours after ingestion with a satisfactory evolution.