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Pamaquine Poisoning in Man, with a Clinicopathologic Study of One Case¹

1. This report is concerned with a case of pamaquine poisoning in which approximately 20 times the therapeutic dose of the drug was given in one day. Death occurred 7 days thereafter.

2. Outstanding early clinical symptoms included apprehension, cyanosis, nausea, and generalized pains; and late symptoms, numbness of the face, difficulty in speaking, dyspnea, and palatal paralysis.

3. Methemoglobinemia and hemoglobinuria occurred soon after the ingestion of the pamaquine.

4. From the standpoint of pathologic anatomy, there was ischemic necrosis with reactive change in a small area of the basis pontis, and mild to moderate degenerative changes in the globus pallidus, nuclei of the extraocular nerves, vestibular nuclei, and cerebral cortex. The outstanding visceral lesion consisted of lobular pneumonia.

¹ From the Army Institute of Pathology, 7th St. and Independence Ave. S.W., Washington 25, D. C.

² Present Address: Institute of Pathology, Rikshospitalet, Oslo, Norway.