Survival Following Severe Paraquat Poisoning a Case Study from the Andaman and Nicobar Islands

Paraquat poisoning continues to pose a significant public health challenge in the Andaman and Nicobar Islands, largely due to its alarmingly high mortality rate. In this report, we present the case of a 39-year-old male farmer who ingested 30 mL of paraquat with the intent of suicide. Initially, the patient underwent prompt gastric lavage and exhibited relative stability. Upon admission, he complained of epigastric pain and vomiting but did not display classic symptoms such as oral ulceration or respiratory distress. Early laboratory findings were unremarkable, with no immediate evidence of organ dysfunction. However, as the days progressed, the patient developed severe non-oliguric renal impairment along with mild hepatic involvement. On the fifth day following ingestion, treatment was initiated with methylprednisolone (1 g intravenously, daily) and N-acetylcysteine (600 mg orally, three times a day), resulting in marked clinical improvement. Notably, his renal function improved rapidly and hepatic dysfunction resolved. Over the next several days, the patient’s serum creatinine levels steadily decreased and liver enzymes normalized. He was discharged on the 12^th day and continued to demonstrate complete recovery upon follow-up. This case highlights the potential benefits of early intervention with immunomodulatory and antioxidant therapies in counteracting the severe toxicity of paraquat, despite the historically poor prognosis associated with such poisonings in the region. The successful outcome in this patient emphasizes the critical role of timely diagnosis, aggressive decontamination, and individualized treatment strategies in resource-limited settings. Further research is essential to optimize treatment protocols and improve survival rates in paraquat poisoning cases, particularly in areas with limited access to advanced healthcare.