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. 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.