Successful outcome after intravenous gasoline injection.
BACKGROUND
Gasoline, ingested intentionally or accidentally, is toxic. The majority of reported cases of gasoline intoxication involve oral ingestion or inhalation. Data are scarce on complications and outcomes following hydrocarbon poisoning by intravenous injection.


METHODS
Following a suicide attempt by intravenous self-injection of 10 ml of gasoline, a 26-year-old medical student was admitted to the intensive care unit (ICU) with hemoptysis, symptoms of acute respiratory failure, chest pain, and severe abdominal cramps. Gas exchange was severely impaired and a chest x-ray indicated chemical pneumonitis. Initial treatment consisted of mechanical ventilation, supportive hyperventilation, administration of nitrogen oxide (NO), and prednisone. Unfortunately, the patient developed multi-organ dysfunction syndrome (MODS) complicated by life-threatening severe vasoplegia within 24 hours after gasoline injection. High doses of vasopressors along with massive amounts of parenteral fluids were necessary. Despite fluid replacement, renal function worsened and required hemofiltration on 5 sequential days. After 12 days of intensive care management, the patient recovered completely and was discharged to a psychiatric care facility.


CONCLUSIONS
Intravenous gasoline injection causes major injury to the lungs, the organ bearing the first capillary bed encountered. Treatment of gasoline poisoning is symptomatic because no specific antidote is available. Early and aggressive supportive care may be conducive to a favorable outcome with minimal residual pulmonary sequelae.
Domej
Wolfgang
W
Department of Internal Medicine, Medical University of Graz, Austria. wolfgang.domej@meduni-graz.at
Mitterhammer
Heike
H
Stauber
Rudolf
R
Kaufmann
Peter
P
Smolle
Karl Heinz
KH
D000328:Adult; D002245:Carbon Dioxide / Q000097:blood; D005742:Gasoline / Q000506:poisoning*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011014:Pneumonia / Q000139:chemically induced* / Q000628:therapy; D011041:Poisoning / Q000209:etiology* / Q000628:therapy; D013902:Radiography, Thoracic; D013406:Suicide, Attempted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005742:Gasoline; D002245:Carbon Dioxide; D010100:Oxygen