Accidental scrotal burns due to paraquat while handling a patient with deliberate self-harm

Abstract

INTRODUCTION: The main risk of paraquat poisoning is from deliberate ingestion. Serious accidental or occupational poisoning is comparatively rare. We report two patients who had accidental exposure to paraquat resulting in scrotal burns in both, and systemic poisoning in one, while attending to a patient who had ingested paraquat for deliberate self harm. CASE REPORT: Two days after death of a patient who had ingested paraquat for deliberate self harm, his brother and a friend who had accompanied him to hospital presented with painful swelling of the scrotum. The brother had severe burns in the scrotal skin sparing the penile skin, and the friend had milder burns in the scrotum. The patient had vomited several times onto the laps of these two men while being brought to hospital in a vehicle. The brother developed mild derangements in hepatic and renal functions suggesting significant systemic absorption. His biochemical and clinical parameters returned to normal over the next 2 weeks on conservative management. In both these patients, the scrotal skin healed without scarring over the next 4 weeks after treatment with silver sulphadiazine local application and amoxicillin given orally. CONCLUSIONS: Precautions should be taken by persons attending to those who have ingested poison. This is especially applicable to patients who have ingested corrosive substances