A 45-year-old male patient with a history of chronic alcoholism was admitted to the emergency department after ingestion of an extra 20% Gramaxone®.
The time elapsed since the ingestion of the herbicide and the amount ingested were not specified.
On physical examination, the patient appears cloudy, tachypneic, tachycardic, moderately swollen and with erythematous lesions in the oral mucosa.
Analytical studies showed a normal blood count, glucose 135 mg/dl and creatinine 1.5 mg/dl. The rest of biochemical determinations revealed normal transaminases and acid-base balance.
The determination of sodium dithionite was positive.
The chest X-ray showed no significant data.
Antibiotic therapy, 20% mannitol, activated charcoal, Mg sulphate and Füller soil were administered, followed by intubation and mechanical ventilation in the Intensive Care Unit.
Later he presented hemodynamic deterioration with good initial response to plasma expanders and vasoactive amines.
In the following hours, the patient presented fever of 40 oC and multiple organ failure with predominantly pulmonary and renal involvement, with no response to treatment including administration of antioxidants and corticosteroids.
After 8 hours of admission, the patient died due to development of cardiac disorders.
