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Published on: June 28, 2018
Fatal Evolution in the Pneumonia Caused by Diesel Fuel Aspiration - Case Report
I O Petrescu1, C S Coşoveanu1, A Popa2
1Discipline of Pediatrics, University of Medicine and Pharmacy of Craiova, Romania.
Insights
Hydrocarbon pneumonitis in infants, often from accidental ingestion, can lead to severe respiratory complications. This case highlights the critical risks, even without typical histopathological findings, emphasizing prompt medical intervention.
Area of Science:
- Pediatric Pulmonology
- Toxicology
- Emergency Medicine
Background:
- Aspiration pneumonia in infants stems from swallowing difficulties, birth defects, or severe reflux.
- Hydrocarbon pneumonitis results from accidental ingestion and lung aspiration, particularly in curious young children.
- While rare due to taste, hydrocarbon ingestion poses significant risks.
Observation:
- An 18-month-old infant ingested diesel, leading to vomiting and delayed hospital admission.
- The infant developed pneumothorax, a complication that resolved with treatment.
- Initial chemical pneumonia progressed to mixed pneumonia due to bacterial overinfection.
Findings:
- The infant tragically died after 12 days in the Anesthesia and Intensive Care Unit.
- Histopathological examination of lung tissue did not reveal characteristic lipid or foam cells.
- The absence of these cells is noted despite their typical association with hydrocarbon pneumonitis.
Implications:
- This case underscores the severe, potentially fatal outcomes of hydrocarbon pneumonitis in infants.
- It highlights diagnostic challenges, as characteristic histopathological markers may be absent.
- Emphasizes the need for vigilance and rapid medical care in suspected hydrocarbon aspiration cases.
Abstract:
Aspiration pneumonia in infants emerges as a result of deglutition disorders, congenital malformations and severe gastroesophageal reflux. Hydrocarbon pneumonitis is caused by the accidental ingestion and aspiration of hydrocarbons into the body. In children, it can be seen as a result of both the lack of monitoring and the tendency for the exploration of the environment. The accidental ingestion of a large quantity is quite rare due to the bad taste of hydrocarbons. Initially, the central nervous system is the one affected, followed by the respiratory system, causing the chemical pneumonia (through direct injury of the lung). Furthermore, we shall present the case of an 18 month infant with severe trauma as a result of the accidental ingestion of diesel, followed by vomiting and who was brought late to the hospital. The pneumothorax that emerged as a complication was remitted after the treatment, but the initially chemical and then mixed pneumonia through bacterial overinfection led to the infant's death after 12 days of medical attention in the Anesthesia and Intensive Care Unit. The histopathological examination of the analyzed lung fragments did not point out any lipid or foam cells that are characteristic to this type of pathology, but which are not mentioned by the majority of toxicology textbooks and those of pathological anatomy, through the low rate of mortality and numerous factors that can lead to negative false results.
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