title: Toluene inducing acute respiratory failure in a spray paint sniffer.
abstract: BACKGROUND
  Toluene, formerly known as toluol, is an aromatic hydrocarbon that is widely used as an industrial feedstock and as a solvent. Like other solvents, toluene is sometimes also used as an inhalant drug for its intoxicating properties. It has potential to cause multiple effects in the body including death.
  
  
  METHODS
  I report a case of a 27-year-old male, chronic spray paint sniffer, who presented with severe generalized muscle weakness and developed acute respiratory failure requiring ventilatory support. Toluene toxicity was confirmed with measurement of hippuric acid of 8.0 g/L (normal <5.0 g/L).
  
  
  CONCLUSIONS
  Acute respiratory failure is a rare complication of chronic toluene exposure that may be lethal if it is not recognized immediately. To our knowledge, this is the second case of acute respiratory failure due to toluene exposure.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, School of Medicine at the Permian Basin, Odessa, TX, U.S.A.
authors.forename: Diego P
authors.initials: DP
authors.lastname: Peralta
authors.forename: Aymara Y
authors.initials: AY
authors.lastname: Chang
keywords: acute respiratory failure; hippuric acid; spray paint sniffer; toluene