Zinc chloride (smoke bomb) inhalational lung injury

Physicians, military and civilian alike, may be called upon to recognize, treat, and provide long-term care to patients who have suffered a zinc chloride (smoke bomb) inhalational injury. Pathologic changes described in the literature include laryngeal, tracheal, and bronchial mucosal edema and ulceration; interstitial edema; interstitial fibrosis; alveolar obliteration; and bronchiolitis obliterans. Acute injury is associated with a high mortality. Following is a report of a patient with a zinc chloride smoke injury which resulted in subpleural emphysematous blebs complicated by pneumothorax and abnormal exercise physiology. Gradual recovery occurred over several months. However, the chest roentgenogram remains abnormal with emphysematous blebs.