Lung ultrasound and kerosene aspiration pneumonitis

Authors

Keywords:

lung ultrasound, kerosene pneumonitis, respiratory insufficiency.

Abstract

Introduction: The ingestion of kerosene leads to the appearance of various complications. Given its low viscosity, in the respiratory system, it is capable of reaching the distal airways and causing lung injury, which requires urgent attention. Lung ultrasound, in medical emergencies, is a pillar that has increased diagnostic capacity, guides decision-making and allows stratifying the patient's prognosis.
Objective: To present a patient with chemical pneumonitis due to aspiration of kerosene, its clinical characteristics and pulmonary ultrasound procedure used.
Clinical case: 68-year-old male patient with a history of alcoholism and epilepsy, which undergoes irregular treatment. He attended Emergency with respiratory distress of several days of evolution and the precedent of ingestion of kerosene, with bronchial aspiration. Lung ultrasound was performed, according to the Bedside Lung Ultrasound in Emergency protocol; severe alveolar interstitial syndrome, thickening of the pleural line, subpleural micro-consolidations, and severe loss of pulmonary aeration were observed. Treatment with invasive mechanical ventilation and antibiotic therapy was established; the pulmonary aeration score improved, and the patient recovered.
Conclusions: Acute respiratory failure secondary to chemical pneumonitis due to kerosene is a complex clinical entity in its evaluation; the use of lung ultrasound is a vital tool that allows the lung parenchyma and pleura to be assessed in real time, in order to make timely and precise therapeutic decisions.

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References

1. Esashi R, Fujikawa H, Kataoka Y, Saito M. Double gastric fluid level and aspiration neumonitis in kerosene poisoning. BMJ Case Rep. 2021; 14:e241560. DOI: 10.1136/bcr-2021-241560

2. Binte Rahman S, Rahman H, Sultana S, Ferdous Khan S, Hossain S, et al. Evaluate the Complication of Kerosene Ingestion. Sch J App Med Sci, 2021 [acceso: 30/05/2022]; 9(4):601-4. Disponible en: https://saspublishers.com/media/articles/SJAMS_94_601-604.pdf

3. Ragab Slima S, Ragab E, Abdalaleem Abdalgeleel S. Evaluation of cases of kerosene poisoning: A 3-year prospective study at Menoufia University Hospitals. Ain Shams J Forensic Med Clin Toxicol. 2021 [acceso: 30/05/2022]; 37(2):34-42. Disponible en: https://ajfm.journals.ekb.eg/article_176834.html

4. Wangüemert Pérez AL. Aplicaciones clínicas de la ecografía pulmonar. Med Clin (Barc), 2020 [acceso: 31/05/2022]; 154(7):260-8. Disponible en: https://doi.org/10.1016/j.medcli.2019.11.001

5. García de Casasolaa G, Casado Lópeza I, Torres Macho J. Clinical ultrasonography in the decision-making process in medicine. Rev Clin Esp. 2019 [acceso: 31/05/2022]; 220(1):49-56. Disponible en: https://doi.org/10.1016/j.rceng.2019.04.004

6. Abdulkhafor Mutlak Y, Ibrahim Mahdi H, Ibrahim Azeez J. Kerosene poisoning in children in Kirkuk city. Kirkuk Journal of Medical Sciences. 2021 [acceso: 01/06/2022]; 9(1):30-46. Disponible en: https://www.iraqjournals.com/article_169936_064b7befc96aeb4f521471417-b6b9f04.pdf

7. Das S, Kumar Behera S, Stanley Xavier A, Selvarajan S. Prophylactic Use of Steroids and Antibiotics in Acute Hydrocarbon Poisoning in Children. Journal of Pharmacy Practice. 2020 [acceso: 01/06/2022]; 33(1):90-95. Disponible en: https://journals.sagepub.com/doi/pdf/10.1177/0897190018771520

8. Heili SB, Peces Barba G. Ecografía pulmonar. El nuevo estetoscopio del Neumólogo del siglo XXI. Medicina Respiratoria. 2014 [acceso: 02/06/2022]; 7(3):55-67. Disponible en: http://www.neumologiaysalud.es/descargas/R7/R73-7.pdf

9. Narula J, Chandrashekhar Y, Braunwald E. Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion, Auscultation, and Insonation. JAMA Cardiol. 2018 [acceso: 02/06/2022]; 3(4):346-50. Disponible en: https://doi.org/10.1001/jamacardio.2018.0001

10. Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier P, Rouby JJ. Comparative Diagnostic Performances of Auscultation, Chest Radiography, and Lung Ultrasonography in Acute Respiratory Distress Syndrome. Anesthesiology, 2004 [acceso: 03/06/2022]; 100:9-15. Disponible en: https://doi.org/10.1097/00000542-200401000-00006

11. Meza Medina CA. Correlación de hallazgos por ultrasonografía pulmonar vs tomografía simple de tórax en pacientes con neumonía por COVID-19 en la unidad de cuidados intensivos del Hospital General las Américas [Tesis de especialidad]. Toluca, México: Universidad Autónoma del Estado de México, Facultad de Medicina, Coordinación de la Especialidad en Medicina del Enfermo en Estado Crítico; 2021 [acceso: 03/06/2022]. Disponible en: http://ri.uaemex.mx/bitstream/handle/20.500.11799/110805/CINTHIA%20-ADRIANA%20MEZA%20MEDINA_TESIS.pdf?sequence=1&isAllowed=y

12. Yang Y, Huang Y, Gao F, Yuan L, Wang Z. Lung ultrasonography versus chest CT in COVID - 19 pneumonia: a two - centered retrospective comparison study from China. Intensive Care Med. 2020 [acceso: 04/06/2022]; 46:1761-3. Disponible en: https://doi.org/10.1007/s00134-020-06096-1

13. Rios Ramirez CA. Evaluación ultrasonográfica de la aireación pulmonar y su comportamiento con la maniobra de reclutamiento alveolar en el paciente con síndrome de distres respiratorio agudo grave secundario a COVID - 19 en la unidad de cuidados intensivos del Hospital General las Américas [Tesis de especialidad]. Toluca, México: Universidad Autónoma del Estado de México, Facultad de Medicina, Coordinación de la Especialidad en Medicina del Enfermo en Estado Crítico; 2021 [acceso: 04/06/2022]. Disponible en: http://ri.uaemex.mx/bitstream/handle/20.500.11799/110814/CARLOS%2-0AARON%20RIOS%20RAMIREZ_TESIS.pdf?sequence=1&isAllowed=y

Published

2023-01-01

How to Cite

1.
Fong Pantoja L, Dieguez Matamoros EB. Lung ultrasound and kerosene aspiration pneumonitis. Rev Cubana Med Milit [Internet]. 2023 Jan. 1 [cited 2025 Jan. 10];52(1):e02302191. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2191

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Section

Case Presentation