[Adverse reaction following suspected inhalation of nickel tetracarbonyl: case report].
BACKGROUND
Nickel tetracarbonyl (Ni(CO)4) is a highly toxic chemical that is produced as an intermediate compound in the Mond process of nickel refining. Occupational poisoning due to Ni(CO)4 is not frequent, and up to now about 300 cases have been reported in the medical literature worldwide.


OBJECTIVE
A clinical case is reported of an industrial worker who developed clinical symptoms of respiratory distress probably due to accidental exposure to Ni(CO), METHODS: Clinical examination, chest X-ray data, history of exposure to nickel in the presence of carbon monoxide (CO) from a production plant that was located close to the reactor containing nickel, led to diagnosis of respiratory distress due occupational poisoning.


RESULTS
Patient history, clinical symptoms that were characteristic of Ni(CO)4 poisoning: mild transient initial symptoms followed within 24 hours by more severe life-threatening events environmental data, history of exposure to nickel near a carbon monoxide (CO) production plant that was located close to the nickel containing reactor, indicated a putative causal relationship between diagnosis and exposure to nickel tetracarbonyl.


CONCLUSIONS
The accident that without adequate respiratory therapy might have had fatal consequences, could have been avoided if the rules of technical and procedural prevention had been carefully observed.
Dipartimento di Medicina Interna e Patologie Sistemiche--Sezione di Medicina del Lavoro, Università di Catania. lproietti@tiscalinet.it
Lidia
L
Proietti
A
A
Ferrara
Velia
V
Freni
A
A
Di Maria
R
R
Polosa
D000062:Accidents, Occupational / Q000517:prevention & control; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002248:Carbon Monoxide / Q000009:adverse effects; D003131:Combined Modality Therapy; D003348:Cortisone / Q000627:therapeutic use; D003951:Diagnostic Errors; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D019983:Guideline Adherence; D006801:Humans; D001239:Inhalation; D007558:Italy; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D010102:Oxygen Inhalation Therapy; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D009942:Organometallic Compounds; C005303:nickel carbonyl; D002248:Carbon Monoxide; D003348:Cortisone