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Hydrocarbon pneumonia

Pneumonia - hydrocarbon

Hydrocarbon pneumonia is caused by drinking or breathing in gasoline, kerosene, furniture polish, paint thinner, or other oily materials or solvents. These hydrocarbons have a very low viscosity, which means that they are very, very thin and slippery. If you tried to drink these hydrocarbons, some would likely slip down your windpipe and into your lungs (aspiration) rather than going down your food pipe (esophagus) and into your stomach. This can easily happen if you try to siphon gas out of a gas tank with a hose and your mouth.

These products cause fairly rapid changes in the lungs, including inflammation, swelling, and bleeding.

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Symptoms

Symptoms may include any of the following:

• Coma (lack of responsiveness)
• Coughing or grunting respiration
• Blue lips and fingernails (cyanosis)
• Fever
• Shortness of breath
• Smell of a hydrocarbon product on the breath
• Stupor (decreased level of alertness)
• Vomiting
• Wheezing

Exams and Tests

At the emergency room, the health care provider will check vital signs, including temperature, pulse, breathing rate, and blood pressure.

The following tests and interventions (actions taken for improvement) may be done in the emergency department:

• Arterial blood gas (acid-base balance) monitoring
• Breathing support, including oxygen, inhalation treatment, breathing tube and ventilator (breathing machine), in severe cases
• Complete blood count (CBC)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Fluids by vein (intravenous or IV)
• Blood metabolic panel
• Toxicology screen

Treatment

Those with mild symptoms should be evaluated by doctors in an emergency room, but may not require a hospital stay. The minimum observation period after inhalation of a hydrocarbon is 6 hours.

People with moderate and severe symptoms are usually admitted to the hospital, occasionally to an intensive care unit (ICU).

Hospital treatment would likely include some or all of the interventions started in the emergency department.

Outlook (Prognosis)

Most children who drink or inhale hydrocarbon products and develop chemical pneumonitis recover fully following treatment. Highly toxic hydrocarbons may lead to rapid respiratory failure and death. Repeated ingestions may lead to permanent brain damage (including memory, attention and judgment deficits, chronic confusion, dementia and psychiatric problems), liver damage, and other organ damage.

Possible Complications

Complications may include any of the following:

• Pleural effusion (fluid surrounding the lungs)
• Pneumothorax (collapsed lung from huffing)
• Secondary bacterial infections

When to Contact a Medical Professional

If you know or suspect that your child has swallowed or inhaled a hydrocarbon product, take them to the emergency room immediately. DO NOT use ipecac to make the person throw up.

Prevention

If you have young children, be sure to identify and store materials containing hydrocarbons carefully.

Related Information

References

Kuschner WG, Blanc PD. Acute responses to toxic exposures. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 103.

Wang GS, Buchanan JA. Hydrocarbons. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 152.

Review Date: 1/1/2021  

Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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