Siphoning diesel: a fatal mistake

Diesel is commonly used as fuel for engines and is distilled from petroleum. Diesel has toxic potential and can affect multiple organs. Exposure can occur after ingestion, inhalation or through the dermal route. The practice of siphoning diesel using a rubber tubing and the mouth is common in rural communities. This can lead to accidental ingestion and aspiration. Here we report a case of a patient who accidentally ingested diesel during siphoning, which caused extensive erosion of the oral cavity and oesophagus leading to pneumomediastinum and severe chemical lung injury. The patient responded well initially to steroids and supportive care but required prolonged hospitalisation. He developed complications of nosocomial infection and succumbed 23 days after admission.

Acute Pneumonitis Induced by Intravenous Thinner Injection in a Case of Suicidal Attempt

A 24 year-old man attempted suicide by injection of 1 cc of thinner into his left antecubital vein; 3 hours later, he visited our emergency room because of left chest pain. We suspected a chemical pneumonitis based on the abnormal findings of his chest X-ray and computed tomography. On the 3rd day after admission, a cellulitis also occurred at the injection area. His symptoms were relieved after supportive care for 2 weeks. There is significant experience with intoxication of thinner inhalation, whereas intoxication of intravenous thinner is rare.

Case of Chemical Pneumonitis and Cellulitis after Suicide Attempt by Arteriovenous Fistula Injection of Gasoline

While much is known concerning intoxication by aspiration of volatile hydrocarbon products, knowledge of intravenous injection of these distillates is rare. This article is a review of various complications after intravascular injection of gasoline. We report a rare case of a suicide attempt of by a male who had chronic renal failure with arteriovenous fistula (AVF). The suicide attempt involved injection of gasoline into the AVF site. After the injection, dermal problem and mild dyspnea developed due to pulmonary edema. These symptoms and radiologic finding of pulmonary edema were similar to those caused by the inhalation of gasoline. The characteristic damage following gasoline inhalation is similar to the present case, and occurs when the gasoline gas spreads to the lung alveoli. In this patient, gasoline entered the AVF site, and the patient developed a soft-tissue phlegmon and cellulitis on the forearm. We did an incision and decompression of the wound, and recreated the AVF site. Two weeks later, the wound was clean and the patient was discharged. The major change after injection of gasoline into the AVF site was chemical pneumonitis, wound inflammation, phlegmon, and malfunction of the AVF site.

A Case of Chemical Pneumonitis Induced by Teflon Inhalation / 대한내과학회지

Chemical pneumonitis is defined as lung irritation caused by inhalation of substances toxic to the lungs. Acute chemical pneumonitis causes swelling of the lung tissue, movement of fluid into the air spaces in the lung, and a decreased ability to absorb oxygen and eliminate carbon dioxide. Teflon (polytetrafluoroethylene) is a commonly used synthetic fiber or insulator. To our knowledge, chemical pneumonitis and acute respiratory failure induced by Teflon inhalation has not been previously reported in Korea. We experienced a 44-year-old patient who had a cough and dyspnea that were aggravated 10 h after smoking tobacco wet by Teflon for 5 min at his workplace. Upon arrival at the emergency room, his blood pressure was low and his arterial blood gas analysis revealed hypoxemia. A chest radiograph showed diffuse haziness on both mid- to-lower lung fields. Following treatment by conservative therapy, including oxygen supply and steroid use, his condition was relatively good and his chest radiograph normalized.

Acute Respiratory Distress Syndrome with Chemical Pneumonitis after Aspiration of Activated Charcoal: A Case Report / 대한구급학회지

Charcoal has been commonly used for enteral detoxication although it causes few adverse effects. The major causes of morbidity and mortality secondary to activated charcoal therapy are pulmonary aspiration, gastrointestinal complication, and fluid and electrolyte abnormalities. Aspiration of charcoal is associated with pulmonary compromise due to increased microvascular permeability with concomitant lung edema, surfactant depletion, atelectasis, and obliterative bronchiolitis. Herein we report the case of a patient with acute respiratory distress syndrome with chemical pneumonitis after aspiration of activated charcoal in sorbitol with a review of the related literatures.

A case of pneumonitis induced by gasoline intoxication / 대한내과학회지

Hydrocarbons are a broad group of organic bodies consisting of hydrogen and carbon. They are commonly found in the environment in the form of gasoline (e.g., butane and propane) and are also used in stain removers, adhesives, lubricants, and a variety of paints. Ingestion of the compound accounts for approximately 3% of all poisoning cases in the United States, but such reports of poisoning are rare in Korea. Hydrocarbon poisoning has many adverse effects. In addition to potentially causing major damage to the respiratory and central nervous systems, direct exposure to hydrocarbons can also cause cardiac arrhythmia, hepatic dysfunction, renal failure, neuropathy, and other injuries. We present the case of a 20-year-old soldier who accidentally ingested a small amount of gasoline. He developed chemical pneumonitis, but recovered with no serious complications.

Two Cases of Chemical Pneumonitis Induced by Hydrocarbon Aspiration / 결핵및호흡기질환

Chemical pneumonitis induced by hydrocarbon aspiration is rare in Korea. Kerosene is a petroleum distillate with low viscosity and high volatility. We report two adult cases of chemical pneumonitis caused by the accidental aspiration of kerosene. They were treated successfully with antibiotics and systemic corticosteroids, and recovered without complications.

Two Cases of Chemical Pneumonitis Caused by Hydrogen Sulfide / 결핵및호흡기질환

Chemical pneumonitis is an occupational lung disease that's caused by the inhalation of chemical substances. Its severity depends on the characteristics of the substances, the exposure time and the susceptibility of the patients. Hydrogen sulfide is not only emitted naturally, but it also frequently found in industrial settings where it is either used as a reactant or it is a by-product of manufacturing or industrial processes. Inhalation of hydrogen sulfide causes various respiratory reactions from cough to acute respiratory failure, depending on the severity. Two pharmaceutical factory workers were admitted after being rescued from a waste water disposal site that contained hydrogen sulfide. In spite that they recovered their consciousness, they had excessive cough and mild dyspnea. The simple chest radiographs and high resolution computed tomography showed diffuse interstitial infiltrates, and hypoxemia was present. They were diagnosed as suffering from chemical pneumonitis caused by hydrogen sulfide. After conservative management that included oxygen therapy, their symptoms, hypoxemia and radiographic abnormalities were improved.

A Case of Acute Respiratory Distress Syndrome Caused by Nitric Acid Inhalation / 결핵및호흡기질환

Nitric acid is an oxidizing agent used in metal refining and cleaning, electroplating, and other industrial applications. Its accidental spillage generates oxides of nitrogen, including nitric oxide (NO) and nitrogen dioxide (NO2), which cause chemical pneumonitis when inhaled. The clinical presentation of a nitric acid inhalation injury depends on the duration and intensity of exposure. In mild cases, there may be no symptoms during the first few hours after exposure, or the typical symptoms of pulmonary edema can appear within 3-24 hours. However, in cases of prolonged exposure, progressive pulmonary edema develops instantaneously and patients may not survive for more than 24 hours. We report a case of a 44-year-old male who was presented with acute respiratory distress syndrome after nitric acid inhalation. He complained of cough and dyspnea of a sudden onset after inhaling nitric acid fumes at his workplace over a four-hour period. He required endotracheal intubation and mechanical ventilation due to fulminant respiratory failure. He was managed successfully with mechanical ventilation using positive end expiratory pressure and systemic corticosteroids, and recovered fully without any deterioration in his pulmonary function.

A Case of Chemical Pneumonitis Caused by Nitric Acid Fume Inhalation / 결핵

Chemical pneumonitis is caused by the inhalation of noxious chemical substances and is a cause of occupational lung disease. Nitric acid, which is a one of the common air pollutants and a potential oxidant for refining and cleansing of metals, has a chance for occupational and environmental exposure. A 52-year-old man visited our hospital due to coughing and dyspnea after the inhalation of nitric acid fumes at his workplace. He had conditions of tachypnea (respiratory rate 26 /min) and hypoxemia (PaO2 42.6 mmHg, SaO2 80.2% in room air) in our emergency department. The chest radiographs showed diffuse interstitial infiltrates and ground glass opacity in both lungs. The patient made improvements in clinical symptoms and chest radiography after being given a supply of oxygen, antibiotics, and bronchodilator therapy without systemic glucocorticoid therapy. On his follow up visit after 4 weeks, he showed no symptoms and sequelae, and the pulmonary function test showed a normal pulmonary function.

Acute Chemical Pneumonitis Caused by Nitric Acid Inhalation: Case Report

Chemical pneumonitis induced by nitric acid inhalation is a rare clinical condition. The previously reported radiologic findings of this disease include acute permeability pulmonary edema, delayed bronchiolitis obliterans, and bronchiectasis. In very few published rare radiologic reports has this disease manifested as acute alveolar injury; we report a case of acute chemical pneumonitis induced by nitric acid inhalation which at radiography manifested as bilateral perihilar consolidation and ground-glass attenuation, suggesting acute alveolar injury.

A case of chemical pneumonitis induced by hydrocarbon ingestion / 대한내과학회지

Chemical pneumonitis induced by hydrocarbon ingestion is rare in Korea. Cresol and xylenol, commonly used hydrocarbon disinfectants, can cause chemical burn on skin, gastrointestinal corrosive injury, central nervous system disturbance, and multiorgan failure including acute respiratory failure and chemical pneumonitis following intoxication1, 2, 8). We will report a case of chemical pneumonitis induced by ingestion of a hydrocarbon disinfectant as suicidal attempt.A 39-years-old female was found unconscious after ingestion of 100-200mL of solution containing cresol (5.5 g/100 mL), xylenol (7.5 g/100 mL), and benzene (37.5 g/100 mL).Upon arriving at emergency room the patient was in coma, had undectable blood pressure (0/0) and had no self respiration. Cardiopulmonary resuscitation were given immediately, resulting in reversed her consciousness and elevated blood pressure.The patient had dermal burn on face, erosion of oral and gastric mucosa, impairment of liver function, leukocytosis, metabolic acidosis with hypoxemia, chemical pneumonitis, and spontaneous pneumothorax. The patient survived after artificial ventilation, intensive general supportive treatment and wound care. She was discharged in relatively good clinical condition with minimal sequele.

A Case of Chemical Pneumonitis Induced by Ingestion of Hydrocarbon / 결핵

A 33-year-old woman was presented with dyspnea and chest discomfort after indigesting approximately 500ml of oil paint brush washing fluid. Hypoxic symptoms and radiographic infiltrates rapidly progressed. The patient was intubated and received mechanical ventilation. Bronchoalveolar lavage and transbronchial lung biopsies were performed. The CT scan of the lung showed bilateral extensive pneumonitis with necrosis and the lung tissue pathologic findings showed diffuse alveolar damage with extensive necrosis and numerous lipidladen macrophages. After intensive medical care with mechanical ventilation, her symptoms and radiological findings improved.

A Case of Chemical Pneumonitis Caused by Acetic acid Fume Inhalation / 결핵

Many organic and nonorganic agents can cause chemical pneumonitis. Chemical pneumonitis induced by inhalation of acetic acid is a rare clinical condition. As acetic acid is a water soluble agent, it causes chemical irritation to respiratory tract and causes variable symptoms. We experienced a case of acute lung injury due to inhalation of acetic acid fume. A 56-year-old male patient was admitted due to dyspnea with vomiting for one day. After he inhaled acetic acid fume in occupational situation, he had chest tightness, chilling sense, and productive cough. Our case was good response to oxygen inhalation, antibiotics, and systemic steroids.