Treatment of 2,4-Dimethylamine Herbicide Intoxication Using Alkaline Diuresis and Pre-emptive Haemodialysis

Introduction: Chlorophenoxy herbicides are class of synthetic herbicides used to control broad leaved weeds. Their poisoning is very rare and l has no antidote. The mission of this case report is to emphasize the role of accurate diagnosis and management of 2, 4-D herbicide intoxication.

Case Report: We report a case of 19 year old male admitted after 6h of the deliberate ingestion of the contents of a half bottle (300 ml) of weedkiller named Dallas contents. Soon after ingestion the patient gave history of vomiting, after which patient became unconscious.

Patient was unresponsive to deep painful stimulus. He was sweating profusely with a temperature of 39 degree Celsius. Patient was electively intubated for airway protection.

Patient’s metabolic acidosis also worsened. Patient’s output dropped to 5-10 ml/hr. Patient was then taken on Haemodialysis. Patient’s urine output improved and GCS also improved.

Conclusion: 2,4-Dimethylamine intoxication is uncommon, doesn’t have an antidote with very high morbidity and mortality. Other therapies, such as gastrointestinal decontamination, first emergency resuscitation, and supportive treatment with haemodialysis when needed, must be added to alkaline diuresis, which is a life-saving treatment.