Black Stone (Paraphenylenediamine) Poisoning: A Case Report

This case report highlights the fatal effects of Paraphenylenediamine (PPD) poisoning, also referred to as “Kala Pathar” in the Urdu language. A 25-year-old male farmer from Balochistan took PPD after suffering from psychological strain due to domestic issues. He first arrived at the ER of a local hospital in Balochistan with significant respiratory distress, dysphagia, and muscle stiffness, which required an emergency intubation and subsequent tracheostomy. Following five days in the hospital, he was discharged prematurely due to financial issues and sent back to the city for further treatment. However, later in that week, his symptoms worsened, including fever, dyspnea, increased respiratory secretions, and decreased responsiveness. He was readmitted and kept in the critical care unit, where he developed acute kidney damage as a result of rhabdomyolysis. Despite receiving intensive care, the patient's condition worsened, and he eventually passed away. This case highlights the dire need for awareness, prompt intervention, and comprehensive mental health and healthcare strategies to combat PPD poisoning in socio-economically vulnerable populations.