Clinical presentation

The severity of herbicide poisoning based on clinical features is outlined in Severity of herbicide poisoning based on clinical features.All patients who have ingested a herbicide are at risk of aspiration pneumonitis.

Table 1. Severity of herbicide poisoning based on clinical features
Severity	Clinical features
mild	mouth or throat pain, nausea, vomiting, diarrhoea sweating
moderate	severe gastrointestinal effects lasting more than 24 hours, gastrointestinal haemorrhage and caustic injury to the oropharynx and oesophagus (see also Caustic ingestions) hypotension that responds to intravenous fluids respiratory distress transient kidney impairment metabolic acidosis agitation, confusion, miosis, nystagmus, ataxia muscle fasciculations, myotonia, limb weakness (can last weeks) methaemoglobinaemia (specific to propanil poisoning)
severe	pulmonary oedema or respiratory failure requiring intubation tachypnoea, tachycardia hyperthermia, rhabdomyolysis kidney failure liver dysfunction metabolic acidosis hyperkalaemia hypotension (hypovolaemia and vasodilation) requiring inotropes, myocardial depression, cardiac arrest coma, seizures death