FIRST CASE REPORT ON METRIBUZINE, AN HERBICIDE SUICIDAL POISONING, PRESENTED WITH FATAL METABOLIC ACIDOSIS, ACUTE RENAL FAILURE, AND HYPOKALEMIA

Background: A 27 years female patient presented within 21 hours of alleged history of suicidal ingestion of Metribuzine, an herbicide, in a drowsy state and with acute renal failure. Clinical Presentation: Patient?s arterial blood gas revelaed severe fatal metabolic acidosis and hypokalemia. Inspite of aggressive resuscitation with early invasive positive pressure ventilation, intravenous crystalloid, intravenous potassium and sodium bicarbonate, patient went into cardiac arrest and after 1 hour of high quality cardiopulmonary resuscitation patient died. During resuscitation clinical signs of pulmonary oedema and hemorrhage also noticed. Discussion and Conclusion: Metribuzine, inspite of being an widely used herbicide, no case has been reported so far, specially with fatal outcome. No data available in human. Animal studies concluded that it is a non acutely toxic herbicide in mammals. Though we differ seeing the fatal outcome in our case and suggest more extensive studies in human.