CASE
A young female presented with burning sensation, ulceration of mouth and oral cavity following the intake of uncooked rice after a quarrel with her parents. Further enquiry revealed that they used boric acid powder as insecticide to preserve the rice. Clinically, she had extensive ulceration with congestion involving the buccal mucosa of lips, oral cavity and tongue (figure 1). Upper gastrointestinal endoscopy also revealed extensive corrosive injury with ulceration, mucosal hyperaemia and slough formatio n involving oropharynx, oesophagus and stomach, for which nasojejunal tube was placed for nutritional supplementation. She also developed acute hepatitis (aspartate aminotransferase 117 U/L, alanine aminotransferase 215 U/L, bilirubin 5.9 mg/dL) with acute renal failure (blood urea 155 mg/dL, serum creatinine 7.6 mg/dL), for which she received supportive care and haemodialysis. After 2 weeks, she developed progressive shortness of breath with ARDS (figures 2 and 3) requiring mechanical ventilation, and subsequently she succumbed...
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