From Household Chemical to Medical Emergency: Stroke Induced by Hydrogen Peroxide Ingestion

Hydrogen peroxide (H₂O₂) ingestion can lead to severe systemic complications, including neurological sequelae such as acute embolic stroke. We present a case of a 49-year-old male who accidentally ingested approximately 50-60 mL of 50% w/w hydrogen peroxide, resulting in encephalopathy, upper motor neuron quadriparesis, and pulmonary artery thrombosis. The patient's altered sensorium progressed to a stupor, accompanied by acute respiratory distress and abdominal gaseous distension. Imaging revealed multifocal hypodensities in the brain and saddle thrombus in the pulmonary arteries. Hyperbaric oxygen therapy initiated after diagnosis led to a significant improvement in motor power and resolution of abdominal distension during hospitalization. The pathophysiology involves gas embolization and oxidative stress-induced thrombosis. Management includes stabilizing the patient, dilution therapy, and supportive care, with hyperbaric oxygen therapy for severe cases. Prevention strategies focus on education and proper storage. Continuous monitoring and follow-up are essential for managing hydrogen peroxide poisoning. This case underscores the need for awareness and prompt intervention in hydrogen peroxide toxicity.