Two-year-old survives lethal paraquat poisoning after timely treatment in Thiruvananthapuram

In a remarkable medical feat, a two-year-old child from Kanyakumari has survived accidental ingestion of paraquat, a highly toxic herbicide, after undergoing intensive treatment at SAT Hospital in Thiruvananthapuram. The child, who weighs just 10 kg, was brought to the hospital within six hours of ingesting the poison, a factor that doctors say was crucial in saving the child's life.

Paraquat poisoning is considered one of the most lethal forms of pesticide poisoning encountered in clinical practice. It can cause complications and death within hours of ingestion, and even a tiny amount can be fatal, especially in young children. Unlike many other poisons, there is no specific antidote for paraquat. The toxin causes painful ulcers in the mouth and gastrointestinal tract, leads to acute kidney and liver injury, and triggers lung inflammation that can result in irreversible pulmonary scarring.

Given the absence of an antidote, treatment focuses on removing the poison from the body as quickly as possible, protecting organ function, and providing intensive supportive care. In this case, the child had already developed renal failure by the time of admission, prompting doctors to opt for haemoperfusion—a procedure in which blood is drawn out of the body, purified, and then returned.

“Extracorporeal treatments in a child as young as two years are challenging due to their small blood volume and the risk of complications. But it was a do-or-die situation. We had to perform three rounds of haemoperfusion over three days to fully clear the toxins from the blood,” said a senior consultant at the hospital. The child's parents were unaware of the exact quantity of poison ingested, making immediate intervention even more critical.

Doctors noted that it was a race against time because once paraquat accumulates in the lungs and other tissues, clearing the toxin becomes extremely difficult. While cases of organophosphorus poisoning are common at SAT Hospital, this was the first time clinicians there managed a case of paraquat poisoning.

One of the major challenges was procuring consumables and purification cartridges suitable for a young child. These cartridges are expensive, and a fresh one was required for each round of haemoperfusion. “Thankfully, we were able to manage the supplies,” the consultant added.

The child, admitted on June 29, has fully recovered. Doctors fondly recalled the joy on the child's face when he was first allowed to sip water after the critical period. However, the child will need continuous follow-up care because paraquat can cause delayed toxicity effects. Regular check-ups are necessary to ensure there is no residual damage to the lungs or other vital organs.

The successful treatment was achieved through the coordinated efforts of the departments of Paediatrics, Pediatric Nephrology, Pediatric Gastroenterology, Paediatric Intensive Care Unit, and the Hemodialysis Unit.

This case draws attention to the broader issue of pesticide safety in India. On July 13 this year, the central government notified a ban on paraquat dichloride, a cheap and widely used weed killer that has been linked to thousands of deaths across the country. While the ban is a step forward, medical experts stress the importance of preventing accidental exposure, especially among children, and ensuring timely access to specialized care in rural and semi-urban areas.