• Anjali Joshi, Aatish Joshi, Shubham Pant, Aakanksha Bhurtyal, and Sunil Yadav.
• Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2024 Jul 31; 62 (276): 548551548-551.

AbstractHerbicide such as 2,4-Dichlorophenoxyacetic acid is commonly used in wheat growing regions and is being ingested with suicidal intent due to easy availability and lack of regulation for buying it. Various articles suggest high fatality upon ingestion of this compound. We report a rare survival of a 24-year-old male who ingested about 45 ml of the compound and presented with symptoms similar to organophosphate poisoning. Before presenting to our hospital, the patient was misdiagnosed and an atropine challenge test and gastric lavage was done. However, after presenting to our center, detailed history was taken and the bottle containing the compound was retrieved, following which the patient was shifted to the intensive care unit where urinary alkalinization and forced diuresis was done. He started getting better and was discharged on fourth day. Detailed history taking can prevent misdiagnosis of 2,4-Dichlorophenoxyacetic acid poisoning. Early diagnosis and adequate supportive management of urinary alkalinization and forced diuresis can improve patient outcomes and reduce fatality.

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