Hydrogen peroxide poisoning presenting as cerebral air gas embolism

We report a rare case of cerebral air embolism following ingestion of hydrogen peroxide, a chemical commonly found in household disinfectants and hair bleaching products. Although often perceived as benign, ingestion of concentrated hydrogen peroxide can cause mucosal injury and life-threatening systemic air embolism. Presentations may range from mild or no symptoms to acute, life-threatening neurological events, yet standardised treatment protocols are lacking. We describe a middle-aged gentleman who presented after accidentally ingesting hydrogen peroxide. He initially experienced retrosternal burning immediately after intake and developed acute weakness a few hours later. Neuroimaging revealed multiple cerebral infarcts caused by air emboli. He was treated with high-concentration oxygen therapy and supportive care, leading to clinical improvement. This case highlights the potential for severe neurological injury from hydrogen peroxide exposure and emphasises the importance of prompt diagnosis and brain imaging when cerebral air embolism is suspected.