Propanil poisoning

Abstract

Objective: To document clinical features of propanil poisoning and discuss treatment.

Design, setting and patients: Five patients treated in the University medical unit at the Karapitiya teaching hospital over the past two years.

Interventions and measurements: Relevant laboratory investigations were done. The patients were treated on accepted lines.

Results: All had methaemoglobinaemia. The first patient died after severe poisoning in spite of intensive treatment. The second had severe poisoning requiring exchange transfusion and treatment with methylene blue. The third, fourth and fifth patients had mild poisoning which responded readily to oral methylene blue. The last patient had taken a combination of propanil and oxydiazone. The first and second patients had features of haemolysis and the second patient had acute hepatitis.

Conclusions: Propanil poisoning is uncommon. Lower levels of methaemoglobin than were previously thought may be associated with a fetal outcome. Methylene blue is used in the treatment as it reduces blood methaemoglobin but in severe poisoning exchange transfusion may be necessary as a life saving measure.