Fatal Propanil Pesticide Poisoning Presenting with Methemoglobinemia

ABSTRACT

Acute propanil pesticide poisoning is rare and propanil is known to have a low toxicity. Propanil metabolite induces the conversion of Fe2+ in hemoglobin to Fe3+, forming methemoglobin. Patients with low metHb levels are asymptomatic, but severe methemoglobinemia produces headache, dizziness, decreased consciousness, convulsion, and death. Thus, delayed diagnosis in patients with severe methemoglobinemia can be lethal. We describe the case of a 60-year-old man who died of acute propanil pesticide poisoning. He presented with severe methemoglobinemia. Early methylene blue therapy is recommended for propanil pesticide poisoning patients with symptoms and signs of methemoglobinemia.