Chen Fan, Ye Yi, Jin Bo, Yi Bo, Wei Qingtao, Liao Linchuan
Department of Forensic Toxicological Analysis, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Forensic Medicine, North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
J Forensic Sci. 2019 May;64(3):941-945. doi: 10.1111/1556-4029.13945. Epub 2018 Nov 19.
Paraquat poisoning usually results from suicide, occupational, or accidental exposure. Herein, we report a rare fatal case of homicidal paraquat poisoning. A 58-year-old man was poisoned by taking paraquat-mixed medicine and wearing paraquat-soaked underwear. In the absence of a history of paraquat exposure, the patient was misdiagnosed with pulmonary infection and scrotal dermatitis and died of respiratory failure 24 days after the initial exposure to paraquat. Ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was applied to detect and quantify paraquat in postmortem specimens. The concentration of paraquat in postmortem specimens from high to low is lung (0.49 μg/g), brain (0.32 μg/g), kidney (0.24 μg/g), liver (0.20 μg/g), cardiac blood (0.11 μg/mL), and stomach wall (<LOQ). Identification of homicidal paraquat poisoning is not easy for a clinician or a forensic pathologist, it is important to consider the possibility of paraquat poisoning when patients suffer from rapidly aggravating pneumonia of unknown origin.
百草枯中毒通常是由自杀、职业接触或意外接触引起的。在此，我们报告一例罕见的百草枯中毒致死案例。一名58岁男性因服用混有百草枯的药物并穿着浸有百草枯的内衣而中毒。由于缺乏百草枯接触史，该患者被误诊为肺部感染和阴囊皮炎，并在首次接触百草枯24天后死于呼吸衰竭。采用超高效液相色谱-串联质谱法（UPLC-MS/MS）检测和定量死后标本中的百草枯。死后标本中百草枯浓度由高到低依次为肺（0.49μg/g）、脑（0.32μg/g）、肾（0.24μg/g）、肝（0.20μg/g）、心血（0.11μg/mL）和胃壁（<最低定量限）。对于临床医生或法医病理学家来说，识别百草枯中毒杀人并不容易，当患者患有不明原因的迅速加重的肺炎时，考虑百草枯中毒的可能性很重要。
