Paraquat poisoning with spontaneous pneumothorax in the era of online shopping

This is a case of a 22-year-old male student who took paraquat as a substance abuse. He presented with flu-like symptoms and chest X-ray depicting changes of acute respiratory distress syndrome (ARDS). After looking at his purchase history in his cell phone, he was found to have purchased paraquat dichloride online and its use was later confirmed by his roommate. The patient developed respiratory distress with renal failure and succumbed to his condition after 11 days of hospital admission. This report highlights an important social issue of probable substance abuse with paraquat which is a commonly used contact herbicide in rural settings but not-so-common in urban population. Also, the report highlights the unusual complication sequalae of pneumothorax. The high mortality with this substance is because of the unavailability of an antidote and of its unscrutinized availability.