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Hydrocarbon Poisoning



 

General Considerations

  • These substances include gasoline, kerosene, lubricating and motor oil, mineral spirits, paint, glues, rubber cement and lighter fluid
  • Accidental ingestion is most common and usually occurs in children under five
  • The target organs from ingestion are the lungs, (most commonly), nervous, cardiac, hepatic, renal, hematologic and dermatologic
  • The lower viscosity of the substance, the higher the chance of aspiration
  • Aspiration is the most commonly reported adverse effect of hydrocarbon ingestion
  • Aspiration produces a direct toxic effect on lung parenchyma resulting in a pneumonitis
  • Hemorrhagic alveolitis can peak 3 days after ingestion

Clinical Findings

  • Respiratory symptoms can be delayed several hours after ingestion
  • Cough and hypoxia
  • Cyanosis
  • Fever

Imaging Findings

  • Initially, the chest radiograph may be normal
  • Symptomatic patients should have a chest x-ray
  • Asymptomatic patients may have a chest x-ray 6 hours after ingestion
  • Findings include airspace disease which may be patchy at the onset but coalesce later, particularly in the lower lobes medially
  • The pattern is similar to, and may represent in some cases, pulmonary edema
  • Pneumatoceles may form after the first week

Treatment

  • Airway, breathing and circulation support
  • Use of emetics is contraindicated
  • Gastric lavage may be performed
  • Antibiotics 

Hydrocarbon Aspiration/Pneumonitis

 
Hydrocarbon Aspiration/Pneumonitis. There is bilateral lower lobe airspace disease, centrally located in the 9 month old child who had ingested kerosene (From Radiology, Resource and Review)

Hydrocarbon Toxicity. MD Levine and C Gresham. eMedicine.