Fatal case of Daisley-Barton Syndrome: A case report with Review of the literature

Abstract

Daisley-Barton Syndrome is a rare but distinct systemic manifestation of paraquat poisoning, characterized by the development of spontaneous pneumothorax and/or pneumomediastinum. We report the case of an adult male in his 40 s, who presented with abdominal pain and vomiting following ingestion of approximately 200 mL of paraquat. Initial management included gastric lavage and supportive care. Over the following days, he developed mucosal ulcerations involving the lips, tongue, and oral cavity, along with progressive respiratory distress. Imaging revealed pneumothorax and pneumomediastinum. Despite intensive care, the patient died due to respiratory failure. Autopsy revealed extensive pulmonary hemorrhage, necrosis, and diffuse alveolar damage consistent with paraquat toxicity. A literature search was conducted using major databases, and relevant case reports describing Daisley-Barton Syndrome were identified. We compared clinical features, radiological findings, outcomes, and autopsy details, where available. Our case is unique in providing both detailed clinical and autopsy findings. The comparison reinforces the diagnostic significance of spontaneous pneumothorax and pneumomediastinum as hallmark features of the syndrome and highlights the variability in clinical course and outcomes. This report emphasizes the importance of early recognition and the role of autopsy in confirming diagnosis and understanding the underlying pathophysiology.