Pretilachlor Poisoning: A Rare Case of Herbicide Poisoning with Neurotoxicity - JAPI Reports - Video

Pretilachlor is a synthetic chloroacetanilide herbicide. Pretilachlor is a broad-spectrum systemic herbicide whose mechanism of action is still not clearly understood. A Case study in the Journal of the associations of Physician of India (JAPI) throws some light on it.

A 58-year-old Indian male presented to the emergency department with an alleged history of oral ingestion of 150 mL of undiluted pretilachlor following which the patient developed a burning sensation in the throat and two episodes of vomiting. The patient was initially taken to a local hospital within 1 hour, where gastric lavage was done with normal saline.

On the first day of hospitalization, the patient had multiple episodes of vomiting and burning sensation in the throat for which he was managed conservatively with antiemetics and proton pump inhibitors. The patient was given benzodiazepines and antiseizure medication. On neurological examination, the plantar reflex was extensor bilaterally, deep tendon reflexes were absent, and an adequate bilateral pupillary response was noted.

Over the next 2 days of hospitalization, supportive therapy was given, along with the addition of IV human albumin, regular chest physiotherapy, and endotracheal tube care. Daily monitoring of Liver Function tests and creatinine was done. Over the next 48 hours, the patient's clinical status improved. He was weaned off from mechanical ventilation and inotropic support was tapered and stopped.

Hence, in conclusion, it was found that pretilachlor poisoning does cause neurotoxic symptoms which range from giddiness, and seizures to even coma. Education and awareness among the treating physicians regarding the neurotoxicity of pretilachlor is an important aspect that needs to be noted in this case report. So, initial stabilization, close monitoring, and supportive treatment are the mainstay of management for pretilachlor poisoning.

Reference: Khasim S, Tanugula SK U, Reddy KR. Pretilachlor Poisoning: A Rare Case of Herbicide Poisoning with Neurotoxicity. J Assoc Physicians India 2022;70(8):93–94.