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Accidental kerosene ingestion: a 3-year prospective study
A A Dudin1, A Rambaud-Cousson, A Thalji
1Department of Paediatrics, Makassed Islamic Charitable Hospital, Jerusalem, Israel.
Insights
Accidental kerosene ingestion in children frequently causes respiratory distress and other severe complications. Early aspiration, not vomiting, appears to be the primary cause of these serious respiratory issues.
Area of Science:
- Pediatrics
- Toxicology
- Public Health
Background:
- Accidental kerosene ingestion is a significant cause of child morbidity and mortality in developing regions.
- Kerosene remains a common household fuel for cooking, heating, and cleaning in many third-world countries.
Purpose of the Study:
- To investigate the clinical manifestations and outcomes of kerosene ingestion in children.
- To identify risk factors and complications associated with accidental kerosene ingestion.
Main Methods:
- A prospective study was conducted involving 78 children aged 10 months to 5 years admitted to Makassed Hospital in Jerusalem.
- Clinical data, including respiratory status, vomiting, chest X-rays, neurological signs, fever, and gastric dilatation, were collected and analyzed.
Main Results:
- Respiratory distress occurred in 76.9% of children; 2 deaths were associated with mechanical ventilation.
- Vomiting did not increase respiratory complication risk, suggesting initial aspiration.
- Chest X-ray abnormalities were present in 60%, pleural effusions in 3 cases, and CNS manifestations in 27% (2 severe cases with convulsions died).
- Severe gastric dilatation occurred in 4 severely ill children, with 2 deaths.
Conclusions:
- Accidental kerosene ingestion poses a severe health risk to children, primarily due to respiratory complications likely from initial aspiration.
- Prompt medical management is crucial for children with kerosene ingestion, as severe cases can lead to fatal outcomes.
- Public health interventions aimed at preventing kerosene ingestion are essential in regions where it is commonly used.
Abstract:
Accidental kerosene ingestion continues to cause morbidity and mortality in third world countries, where kerosene is still used for cooking, heating and cleaning. In this prospective study, 78 children aged from 10 months to 5 years were managed at Makassed Hospital in Jerusalem for kerosene ingestion. Respiratory distress developed in 60 (76.90%) children. Two who required mechanical ventilation died. Vomiting, which occurred in 49 cases, did not seem to increase the risk of respiratory complications, suggesting that aspiration occurs with the initial ingestion. Chest X-ray changes were noted in 60% of the children on admission. Pleural effusions occurred in three cases over 24 hours after the incident. CNS manifestations, most likely caused by anoxia, were seen in 27% of the children, but in only two were they severe in the form of convulsions, and both died. Fever occurred in about 50% of the children during their stay in hospital. Severe gastric dilatation developed in the four most severely ill children, two of whom died. The quantity of kerosene ingested by them was estimated to be large.