[ARDS caused by military zinc fumes exposure]

A previously healthy 19-year-old male was exposed to concentrated hexite smoke (ZnCl2) for several minutes during military training. The initial symptoms (vomiting, cough, dyspnea) disappeared after a few hours. After 48 hours the patient developed acute respiratory distress syndrome requiring tracheal intubation and mechanical ventilation for 8 days. He left hospital 10 days after extubation. Spirometry at this time revealed a restrictive defect (vital capacity 50% predicted). Four months after the accident the patient had returned to work without symptoms of respiratory insufficiency. Lung function tests had normalized with the exception of a slight reduction in carbon monoxide diffusion. This case illustrates the typical course of inhalative intoxication with hexite. It underlines the importance of prolonged clinical surveillance in view of the latency between the initial symptoms of hexite intoxication and possible later development of ARDS.