A Case of Propanil Poisoning Managed with Manual Red Cell Exchange

We present a case of propanil poisoning in a 23-year-old male diagnosed with depression and seizure disorder. Initially, the patient was managed with IV methylene blue; however, red cell exchange was indicated as the clinical condition was deteriorating. Facilities were not available to perform an automated red cell exchange. Hence, a manual red cell exchange was arranged, in which the patient’s whole blood was withdrawn, and healthy donor red cells were transfused with plasma. After three manual exchanges, the patient improved. This case suggests that red cell exchange is lifesaving in propanil poisoning, which can be accomplished manually.