Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5588
Peer-review started: December 26, 2020
First decision: April 29, 2021
Revised: May 7, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: July 16, 2021
Processing time: 192 Days and 19.8 Hours
Paraquat is an effective, broad-spectrum, highly toxic quaternary ammonium herbicide. Paraquat poisoning has been reported frequently in recent years. It has severe lung, kidney, liver, and nervous system toxicity, and there is currently no specific antidote. Paraquat poisoning may follow ingestion, inhalation, and skin contact. There have been no previous reports of paraquat poisoning that resulted from kissing. This rare case provides a new reference for the prevention of paraquat poisoning.
A 27-year-old man came to the emergency department complaining that he had come into contact with paraquat by kissing his girlfriend, who had taken 80-120 mL 20% paraquat. After admission, his lung computed tomography (CT) showed increased lung markings. Redness and a burning sensation developed on his tongue, which progressed to painful erosions and coalescent ulcers. The final diagnosis was mild paraquat poisoning. Anti-inflammatory, antioxidant, and symptomatic treatment were initiated and continued for 7 d. Dyspnea did not occur, subsequent lung CT showed no significant changes, and the tongue pain was slightly improved. One month after discharge, the tongue injury was resolved.
This case indicated that the tongue and lung tissues are particularly vulnerable to paraquat toxicity, even after a limited exposure.
Core Tip: We report a rare case of exposure to a trace amount of paraquat by kissing, which has never been reported before. This case was accidental, but it reminds us that we should pay attention to trace paraquat poisoning because it has damaging effects, especially on the tongue.