Rapid Successful Management of Diffuse Alveolar Hemorrhage as the Primary Presentation of Chlorine Gas Inhalation: A Rare Case Report

Mohsen Yaghubi; Morteza Valaei; Reza Ghasemi; Mahmood Hosseinzadeh Maleki; Sara Rezaei; Samaneh Kakhki

doi:10.18502/acta.v59i10.7770

Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran
Morteza Valaei Department of Internal Medicine, Razavi Hospital, Imam Reza International University, Mashhad, Iran
Reza Ghasemi Department of Cardiology, 9 Dey Educational Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
Mahmood Hosseinzadeh Maleki Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Sara Rezaei Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Samaneh Kakhki Department of Clinical Biochemistry, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

DOI: https://doi.org/10.18502/acta.v59i10.7770

Keywords: Diffuse alveolar hemorrhage (DAH); Acute respiratory distress syndrome (ARDS); Chlorine gas inhalation; Corticosteroids

Abstract

Chlorine-containing bleach, as a common disinfectant, can cause mild to severe symptoms from nasal irritation to life-threatening conditions such as acute respiratory distress syndrome (ARDS). However, the toxicity level of chlorine gas depends on the duration and concentration of exposure. Herein, we describe the case of a 44-year-old man admitted to the emergency department with a chief complaint of severe shortness of breathing and hemoptysis following accidental, short-time exposure to chlorine-containing bleach. Because of the life-threatening condition, he was transferred to the Intensive Care Unit (ICU) and received mechanical ventilation along with a corticosteroid agent and antibiotic therapy. Despite limited data on management of the severe complications of the exposure, the patient successfully recovered after four days.