Systemic Paraquat Intoxication Presenting with Peripheral Ulcerative Keratitis: A Case Report and Literature Review

Ocul Immunol Inflamm. 2020 Aug 17;28(6):871-875. doi: 10.1080/09273948.2019.1640882. Epub 2019 Aug 14.

Abstract

Purpose: To describe a rare case of systemic paraquat poisoning presenting with peripheral ulcerative keratitis.

Methods: Case report and literature review.

Results: Two days after a mouthful of paraquat ingestion, a 48-year-old man presented with painful oral ulcers, abnormal liver functions, and acute kidney injury, followed by the development of crescent-shaped corneal erosions along the limbus and progressive visual impairment in both eyes. Paraquat-induced peripheral ulcerative keratitis was suspected and the patient was treated with intensive topical steroid along with systemic steroid. He recovered completely with good visual outcomes after treatment.

Conclusions: Peripheral ulcerative keratitis is usually an immune-mediated ocular condition, and may be a complication associated with systemic paraquat poisoning. Proper diagnosis and adequate treatment are important for visual recovery.

Keywords: Complications; inflammation; paraquat; peripheral ulcerative keratitis; visual impairment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Chemical and Drug Induced Liver Injury / etiology
  • Corneal Ulcer / chemically induced*
  • Corneal Ulcer / diagnosis
  • Herbicides / poisoning*
  • Humans
  • Kidney Function Tests
  • Liver Diseases
  • Liver Function Tests
  • Male
  • Middle Aged
  • Oral Ulcer / chemically induced
  • Paraquat / poisoning*

Substances

  • Herbicides
  • Paraquat