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一例百草枯中毒并发自发性气胸和纵隔气肿

A Case of Paraquat Poisoning Presenting With Spontaneous Pneumothorax and Pneumomediastinum.

作者信息

Sahoo Debananda, Kar Nilanjan, Devi Sujata, Dey Anupam, Das Dhriti Sundar

机构信息

Internal Medicine, All India Institute of Medical Sciences, Bhubaneswar, IND.

General Medicine, All India Institute of Medical Sciences, Bhubhaneswar, IND.

出版信息

Cureus. 2020 Dec 7;12(12):e11943. doi: 10.7759/cureus.11943.

Abstract

Paraquat (1,1'-dimethyl-4,4'-dipyridylium) is a liquid herbicide associated with accidental and suicidal ingestion, leading to fatal toxicity. It can lead to multiple organ dysfunction, including metabolic acidosis, acute kidney and liver injury, pulmonary fibrosis, and acute respiratory distress syndrome (ARDS). Very rarely, this can present with spontaneous pneumothorax or pneumomediastinum or both, which are poor prognostic markers with a mortality rate of almost 100%. Here, we present a young male presenting with paraquat poisoning followed by the development of both pneumothorax and pneumomediastinum and death from respiratory failure. Paraquat poisoning should always be considered in the differential diagnosis in patients presenting with spontaneous pneumothorax or pneumomediastinum in places with high paraquat poisoning prevalence.

摘要

百草枯(1,1'-二甲基-4,4'-联吡啶阳离子)是一种液体除草剂,与意外和自杀性摄入有关,可导致致命毒性。它可导致多器官功能障碍,包括代谢性酸中毒、急性肾和肝损伤、肺纤维化以及急性呼吸窘迫综合征(ARDS)。非常罕见的情况下,它可表现为自发性气胸或纵隔气肿或两者兼有,这些都是预后不良的指标,死亡率几乎为100%。在此,我们报告一名年轻男性,因百草枯中毒继发气胸和纵隔气肿,并死于呼吸衰竭。在百草枯中毒患病率高的地区,对于出现自发性气胸或纵隔气肿的患者,鉴别诊断时应始终考虑百草枯中毒。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/137d/7785492/a01392aa09a7/cureus-0012-00000011943-i01.jpg

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