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Abdul Malik AA, Ng BH, Nik Abeed NN, Abdul Hamid MF, Ban AY. Hydrofluorocarbons pneumonitis as a complication of inhalation injury following air‐conditioning repairs. Respirol Case Rep 2022; 10:e0983. [PMID: 35685849 PMCID: PMC9171686 DOI: 10.1002/rcr2.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/17/2022] [Indexed: 11/12/2022] Open
Abstract
Hydrofluorocarbon (HFC) pneumonitis is an uncommon cause of inhalation injury. HFCs are a group of chemicals predominantly used for refrigeration and cooling. A 19‐year‐old air‐conditioning technician developed acute onset of dyspnoea and chest tightness while servicing an air conditioner in a confined space. We diagnosed him with HFC pneumonitis based on the history of exposure and the high‐resolution computed tomography (HRCT) thorax findings. He was treated with steroids and supportive oxygen therapy. He recovered fully after 5 days of hospitalization and was discharged. Review at 2 weeks in the outpatient setting showed significant radiological improvement on HRCT thorax.
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Affiliation(s)
- Afifah Aqilah Abdul Malik
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Boon Hau Ng
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Nik Nuratiqah Nik Abeed
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Mohamed Faisal Abdul Hamid
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Andrea Yu‐Lin Ban
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
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Reddy R, Baek J, Perone HR, Chen K, Lichtstein DM. The Hurricane Lung: A Case of Hydrocarbon Pneumonitis With Abscess Formation Following Fuel Siphoning. Cureus 2021; 13:e14807. [PMID: 34094763 PMCID: PMC8169091 DOI: 10.7759/cureus.14807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2021] [Indexed: 11/24/2022] Open
Abstract
Fuel siphoning is a widespread practice worldwide, but infrequently observed in the United States. Some reports suggest greater incidence of fuel siphoning during the hurricane season. Fuel siphoning is associated with a high risk of hydrocarbon toxicity, often leading to the development of hydrocarbon pneumonitis. This form of exogenous lipoid pneumonia can present acutely with chest pain and dyspnea. While most cases of hydrocarbon pneumonitis resolve spontaneously with supportive care, rarely patients develop life-threatening complications. We present the case of a 56-year-old man who developed hydrocarbon pneumonitis complicated by abscess formation after attempting to siphon fuel from a gasoline tank in preparation for a hurricane.
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Affiliation(s)
- Renuka Reddy
- Internal Medicine, University of Miami JFK Medical Center, Atlantis, USA
| | - Jessica Baek
- Internal Medicine, University of Miami JFK Medical Center, Atlantis, USA
| | - Hanna R Perone
- Internal Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Kai Chen
- Internal Medicine, University of Miami JFK Medical Center, Atlantis, USA
| | - Daniel M Lichtstein
- Internal Medicine, University of Miami Miller School of Medicine, Miami, USA
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Chen YJ, Hsu CC, Chen KT. Hydrocarbon pneumonitis following fuel siphonage: A case report and literature review. World J Emerg Med 2019; 10:69-74. [PMID: 30687441 DOI: 10.5847/wjem.j.1920-8642.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND People sometimes siphon fuel to fill their tanks. However, this is a potentially dangerous procedure and may cause hydrocarbon pneumonitis. We present the case of a patient with severe hydrocarbon pneumonitis after siphoning fuel. The patient underwent artificial ventilation and was admitted to hospital for 97 days. METHODS We review the relevant literature for a better understanding of clinical features and management strategies for hydrocarbon pneumonitis following fuel siphonage. RESULTS We reviewed 15 articles, which included 3 original articles and 12 case reports that reported the clinical features of fuel siphonage. In addition, we added our presented case for data analysis. A total of 40 cases were included in this review. The literature review found that hydrocarbon pneumonitis caused by fuel siphonage occurs worldwide and that most patients (80%) became symptomatic within 1 day of aspiration. Cough (70%), chest pain (62.5%), dyspnoea (55%), and fever (52.5%) presented in more than half of all patients. The right middle lobe (80%) was the predominantly involved lung field; more than one-third of patients (36.7%) showed the involvement of two lobes. CONCLUSION Patient history, computed tomographic scans of the chest, and bronchoalveolar lavage are the commonly used diagnostic tools. Supportive care remains the foundation of treatment, whereas antibiotics, steroids, and bronchoalveolar lavage are practical therapies. Patients' clinical improvement precedes the resolution of lesions on chest X-ray. Most complications arise from pulmonary lesions. The prognosis of patients suffering from hydrocarbon pneumonitis following fuel siphonage might be improved by accurate diagnosis and appropriate care.
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Affiliation(s)
- Yi-Jung Chen
- Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan, China
| | - Chien-Chin Hsu
- Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan, China.,Department of Biotechnology, Southern Tainan University of Technology, Tainan, Taiwan, China
| | - Kuo-Tai Chen
- Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan, China.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, China
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Hara M, Iwakami S, Sumiyoshi I, Yoshida T, Sasaki S, Takahashi K. Hydrocarbon pneumonitis caused by the inhalation of wood preservative. Respirol Case Rep 2018; 6:e00379. [PMID: 30386622 PMCID: PMC6203695 DOI: 10.1002/rcr2.379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 11/16/2022] Open
Abstract
A 69-year-old man was admitted to our hospital with acute dyspnoea, which developed after using a wood-preserving agent in an enclosed space. Burn injuries were evident on his face, neck, chest, and both upper arms. Bronchoalveolar lavage was carried out. The collected fluid resembled wood preservative. Subsequently, it was established that kerosene was a major component of the wood preservative. A diagnosis of hydrocarbon pneumonitis was established. The patient's respiratory and general findings improved with intensive care, which included mechanical ventilation. Corticosteroid was not required to aid his recovery. Aspiration and/or inhalation of hydrocarbon compounds, such as kerosene, turpentine, and gasoline, can cause acute and fatal pneumonitis. In managing cases of hydrocarbon pneumonitis, a prompt diagnosis and appropriate supportive care are important to achieve a good outcome.
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Affiliation(s)
- Munechika Hara
- Department of Respiratory MedicineJuntendo University Shizuoka HospitalIzunokuniShizuokaJapan
| | - Shin‐ichiro Iwakami
- Department of Respiratory MedicineJuntendo University Shizuoka HospitalIzunokuniShizuokaJapan
| | - Issei Sumiyoshi
- Department of Respiratory MedicineJuntendo University Shizuoka HospitalIzunokuniShizuokaJapan
| | - Takashi Yoshida
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineBunkyo‐KuTokyoJapan
| | - Shinichi Sasaki
- Department of Respiratory MedicineJuntendo University Urayasu HospitalUrayasuChibaJapan
| | - Kazuhisa Takahashi
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineBunkyo‐KuTokyoJapan
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McKee RH, White R. The mammalian toxicological hazards of petroleum-derived substances: an overview of the petroleum industry response to the high production volume challenge program. Int J Toxicol 2013; 33:4S-16S. [PMID: 24351873 DOI: 10.1177/1091581813514024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Petroleum-derived substances are complex and composed of aliphatic (normal-, iso-, and cycloparaffins), olefinic, and/or aromatic constituents. Approximately 400 of these complex substances were evaluated as part of the US Environmental Protection Agency voluntary High Production Volume (HPV) Challenge program. The substances were separated into 13 groups (categories), and all available data were assessed. Toxicology testing was conducted as necessary to fully address the end points encompassed by the HPV initiative. In a broad sense, volatile hydrocarbons may cause acute central nervous system effects, and those that are liquids at room temperature pose aspiration hazards if taken into the lungs as liquids and may also cause skin irritation. Higher boiling substances may contain polycyclic aromatic constituents (PACs) that can be mutagenic and carcinogenic and may also cause developmental effects. Substances containing PACs can also cause target organ and developmental effects. The effects of aliphatic constituents include liver enlargement and/or renal effects in male rats via an α-2u-globulin-mediated process and, in some cases, small but statistically significant reductions in hematological parameters. Crude oils may contain other constituents, particularly sulfur- and nitrogen-containing compounds, which are removed during refining. Aside from these more generic considerations, some specific petroleum substances may contain unusually toxic constituents including benzene, 1,3-butadiene, and/or n-hexane, which should also be taken into account if present at toxicologically relevant levels.
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Affiliation(s)
- Richard H McKee
- ExxonMobil Biomedical Sciences, Inc, 1545 US Highway 22 East, Annandale, NJ 08801, USA.
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Shrivastava MS, Palkar AV, Karnik ND. Hydrocarbon pneumonitis masquerading as acute lung injury. BMJ Case Rep 2011; 2011:bcr.03.2011.4017. [PMID: 22689551 DOI: 10.1136/bcr.03.2011.4017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hydrocarbon pneumonitis is an acute, intense pneumonitis resulting from aspiration/inhalation of volatile hydrocarbon compounds with low viscosity and surface tension. The authors describe the case of a 24-year-old male who aspirated diesel while siphoning it from heavy duty crane, developed bilateral pneumonitis and responded to 2-day therapy with non-invasive continuous positive airway pressure ventilation.
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Argibay A, Sopeña B, Maure B, Pazos N, Pérez-Rodríguez M, Martínez-Vázquez C. La clave estaba en la historia clínica. Rev Clin Esp 2008; 208:367-8. [DOI: 10.1157/13124321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Balu L, Gasc JM, Boccon-Gibod L, De Vries P, Blanc P, Guigonis V, Deschênes G, Bensman A, Ulinski T. Arterial hypertension and ovarian tumour in a girl: what is the link? Nephrol Dial Transplant 2004; 20:231-4. [PMID: 15328387 DOI: 10.1093/ndt/gfh477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Laurent Balu
- Department of Pediatric Nephrology, Hôpital Trousseau, 26, Av. du Docteur Netter, 75012 Paris, France
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McKee RH, Trimmer GW, Whitman FT, Nessel CS, Mackerer CR, Hagemann R, Priston RA, Riley AJ, Cruzan G, Simpson BJ, Urbanus JH. Assessment in rats of the reproductive toxicity of gasoline from a gasoline vapor recovery unit. Reprod Toxicol 2000; 14:337-53. [PMID: 10908837 DOI: 10.1016/s0890-6238(00)00085-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Gasoline (CAS 86290-81-5) is one of the world's largest volume commercial products. Although numerous toxicology studies have been conducted, the potential for reproductive toxicity has not been directly assessed. Accordingly, a two-generation reproductive toxicity study in rats was conducted to provide base data for hazard assessment and risk characterization. The test material, vapor recovery unit gasoline (68514-15-8), is the volatile fraction of formulated gasoline and the material with which humans are most likely to come in contact. The study was of standard design. Exposures were by inhalation at target concentrations of 5000, 10 000, and 20 000 mg/m(3). The highest exposure concentration was approximately 50% of the lower explosive limit and several orders of magnitude above anticipated exposure during refueling. There were no treatment-related clinical or systemic effects in the parental animals, and no microscopic changes other than hyaline droplet nephropathy in the kidneys of the male rats. None of the reproductive parameters were affected, and there were no deleterious effects on offspring survival and growth. The potential for endocrine modulation was also assessed by analysis of sperm count and quality as well as time to onset of developmental landmarks. No toxicologically important differences were found. Therefore, the NOAEL for reproductive toxicity in this study was > or =20 000 mg/m(3). The only systemic effects, in the kidneys of the male rats, were consistent with an alpha-2 u-globulin-mediated process. This is a male rat-specific effect and not relevant to human health risk assessment.
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Affiliation(s)
- R H McKee
- Exxon Biomedical Sciences, Inc., Annandale, NJ 08801, USA.
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Abstract
Although it is generally acknowledged that benzene causes leukemia, especially acute myeloid leukemia, considerable divergences persist in the assessment of the leukemia risk due to occupational low-level benzene exposure. Specifically, the risk for vehicle mechanics is considered by some authors as being nondetectable with epidemiologic methods, whereas others calculated that the incidence rate of leukemia (all types) in vehicle mechanics is increased more than 60 times. The purpose of this review is to examine the publications on this topic in light of criteria for causal inference and to discuss the possible role of bias, confounding factors, and chance. The results of this analysis reveal that there are surprisingly few epidemiologic observations supporting an increased incidence of leukemia in vehicle mechanics. Apparently, publications suggesting a leukemogenic effect of low-level benzene exposure in garage mechanics are more often quoted than their negative counterparts, although they are not better designed.
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Affiliation(s)
- P Hotz
- Unit of Industrial Toxicology and Occupational Medicine, Catholic University of Louvain, Brussels, Belgium
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