Accidental formalin poisoning in a child with acute fatal manifestations: A rare case report

Sahu, Sindhu Sudha; Naveen, Alagarasan; Mohanty, Manoj Kumar; Kundu, Anirban

doi:10.4103/jfmpc.jfmpc_1790_21

Cited by 1 publication

(5 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anuria was not observed in this case as described in some human reports 13,16 and diuresis appeared to be sufficient protection against further potential renal tubular epithelial injury. IV fluid therapy was continued until Day 6 as tubular epithelial regeneration was expected to take numerous days should injury have occurred.…”

Section: Discussionsupporting

confidence: 59%

“…In human medicine, formalin ingestion is rare with majority of reports in the literature being accidental, suicidal or homicidal 5,13,14,16,17,25–27 . Gastrointestinal signs are accompanied by metabolic acidosis and MODS.…”

Section: Discussionmentioning

confidence: 99%

“…In human medicine, formalin ingestion is rare with majority of reports in the literature being accidental, suicidal or homicidal. 5,13,14,16,17,[25][26][27] Gastrointestinal signs are accompanied by metabolic acidosis and MODS. Gastrointestinal signs in humans are characterised by nausea, abdominal pain, vomiting, diarrhoea, haematemesis, and melena due to local corrosion of the gastrointestinal mucosa and secondary necrosis, inflammation, ulceration and potential perforation.…”

Section: Discussionmentioning

confidence: 99%

“…In both human and veterinary scientific literature, precise lethal doses remain undetermined. However, ingestion of >10 g of formaldehyde by an adult human is known to be fatal, and fatal doses less than this have also been reported across the world 5,13–17 . Ten grams of formaldehyde would equate to a lethal dose of 0.12–0.16 g/kg in an average adult human 18 .…”

Section: Introductionmentioning

confidence: 99%

“…However, ingestion of >10 g of formaldehyde by an adult human is known to be fatal, and fatal doses less than this have also been reported across the world. 5,[13][14][15][16][17] Ten grams of formaldehyde would equate to a lethal dose of 0.12-0.16 g/kg in an average adult human. 18 This report describes the successful medical management of formalin intoxication in an adult horse after accidental administration via nasogastric intubation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Survival of formalin intoxication in a 13‐year‐old Thoroughbred gelding

Lovett,

Vokes,

Loghides

et al. 2023

Equine Veterinary Journal

View full text Add to dashboard Cite

BackgroundFormalin intoxication via the gastrointestinal route has not been previously reported in the horse. Whereas ingestion of formalin in humans, although rare, is well documented. Majority of human cases are either accidental, suicidal or homicidal and often lead to fatality, with a reported lethal formaldehyde dose equating to 0.12 – 0.16 g/kg bwt.AimsTo describe a single case report of the clinical management of an adult horse referred to a veterinary teaching hospital following accidental administration of 10% formalin via nasogastric tube.Materials & MethodsA 13‐year‐old Thoroughbred gelding originally presented to the referring veterinarian for colic where 1.8 L of 10% formalin was accidentally administered instead of mineral oil via nasogastric intubation, a potentially lethal dose of formaldehyde (0.12 g/kg bwt). Approximately 20‐hours following 10% formalin administration the horse was admitted to the referral hospital with moderate tachycardia, occasional ectopic beats, tacky and hyperaemic mucous membranes, delayed capillary refill time, reduced borborygmi, and pronounced digital pulses. Diagnostic investigations included laboratory blood analysis, urinalysis, electrocardiogram, abdominal ultrasound, palpation per rectum and gastroscopy.ResultsPatient assessment found evidence of toxicity to the gastrointestinal tract, hypovolaemia and risk for laminitis. Intensive care included fluid and electrolyte therapy, anti‐inflammatories and analgesia, continuous digital cryotherapy, gastro‐protectants and other methods of gastrointestinal support. The horse was discharged from hospital on day 14 with no long‐term complications and the client‐veterinarian relationship was preserved.DiscussionIn human cases of ingestion, gastrointestinal injury is typically accompanied by severe metabolic acidosis and multiple organ dysfunction syndrome due to toxicity of other body systems that can contribute to non‐survival. Formaldehyde toxicity in the present case predominantly affected the gastrointestinal tract, most likely a direct result of the route of administration. Aside from gastrointestinal injury, primary toxicity of other body systems was not confirmed. To prevent this medical error recurring, the referring veterinary clinic revised their labelling and storage of 10% formalin.ConclusionThis is the first report of systemic formalin intoxication in the horse. Following a high dose of 10% formalin (0.12 g/kg bwt formaldehyde) enterally, the horse survived having received intensive supportive care based on human guidelines for ingested formalin.

show abstract

Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%