Propanil Poisoning Presenting with Methaemoglobinemia: A Case Report.

Propanil is an uncommon cause of poisoning, and the incidence of it in India is unknown. It is a low to medium toxicity agent; however, severe poisoning can lead to death, especially in areas with limited medical facilities. Hereby, the authors present a case of 15-year-old girl who presented to Emergency Department after 72 hours of ingesting an unknown quantity of propanil. She was noted to have peripheral cyanosis, laboured breathing, and a room air saturation of 62%, for which she was intubated and ventilated. Methaemoglobinemia was suspected in the child, which is considered a complication of propanil poisoning, and methylene blue was administered within six hours of admission. Exchange transfusion was performed via a femoral central line catheter when there was no improvement with methylene blue. Sulfhaemoglobinemia was also considered as a differential diagnosis. On day 4 of the hospital stay, her saturation improved to 80%. She experienced complications of haemolysis, which were managed conservatively. She improved clinically and was extubated on day 5. Her room air saturation was 93% on day 9, and she was discharged. She had a follow-up appointment in the outpatient clinic after two weeks, where her saturation on room air was recorded as 97%, and her methaemoglobin levels were 8.7% in the postexchange transfusion sample. Propanil has the potential to cause severe, life-threatening clinical symptoms. Exchange transfusions can be lifesaving in situations of severe poisoning. Early transfer of patients to tertiary care Institutions should be considered as peripheral hospitals may lack intensive care facilities and exchange transfusion capabilities. [ABSTRACT FROM AUTHOR]