Acute inhalation injury with evidence of diffuse bronchiolitis following chlorine gas exposure at a swimming pool.
A previously healthy 23-year-old man with nonproductive cough and sore throat presented to the hospital a few hours after chlorine gas exposure at a fitness center swimming pool. Initial physical examination and chest radiograph were normal. Thirty-six hours later he developed worsening dyspnea and cough, with development of blood-tinged sputum. Arterial blood gas analysis showed mild hypoxemia and a subsequent chest radiograph demonstrated diffuse tiny nodular opacities. Findings on a thin-section computed tomogram of the chest were consistent with diffuse bronchiolitis. Pulmonary function tests showed a mild obstructive abnormality and he demonstrated substantial bronchodilator response. The patient was treated with oral corticosteroids and an inhaled beta(2) agonist, to which he responded well, with full clinical recovery occurring over 5 months. This manifestation of chlorine gas exposure at a swimming pool is unusual.
Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Box 359762, 325 Ninth Avenue, Seattle, WA 98104, USA.
Tanyalak
T
Parimon
Jeffrey P
JP
Kanne
David J
DJ
Pierson
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D001988:Bronchiolitis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002713:Chlorine / Q000506:poisoning*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D012129:Respiratory Function Tests; D013551:Swimming Pools
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D002713:Chlorine; D000420:Albuterol