Ingestion of formic acid-containing agents--report of three fatal cases

Abstract

Three patients were treated after they had deliberately ingested domestic agents containing formic acid. The major complications included the local effects on the oropharynx, oesophagus and stomach, metabolic acidosis, derangement of clotting mechanisms with haemorrhage and shock, widespread intravascular haemolysis, disseminated intravascular coagulation and the acute onset of respiratory and renal failure. All 3 patients died between 2 and 14 days after admission. It is the authors’ belief that intensive therapy from the outset to include exchange transfusion, infusion of clotting factors, high dose steroids, ventilatory support and peritoneal or haemodialysis with parenteral nutrition may perhaps offer a better chance for survival.

Suicidal chemistry: combined intoxication with carbon monoxide and formic acid

“…Histology analysis (Table 1) determined a complete lack of the respiratory epithelium of the trachea, edema of mucosa and submucosa of the trachea, thrombi and hemolysis inside the small vessels of the trachea, pulmonary edema, hemolysis and thrombosis in the lung vessels. These findings are connected with formic acid injury to the tissue and the effect on the coagulation system [6,19,20]. On the other hand, there were no significant injuries to the gastrointestinal tract.…”

Acute Formic Acid Poisoning: A Case Series Analysis with Current Management Protocols and Review of Literature

“…1,5,6 Clinical features depend on the quantity of ingestion and usually present with vomiting, respiratory distress, hematemesis and hematuria. 7 Hematochezia and blood vomitus may be seen with 30 to 4 ml FA ingestion associa ted with acute abdomen and dark red urine. 7,8 Common complaints were oral cavity burns, metabolic acidosis, septicemia, dysphagia, esophageal stricture, gastrointestinal perforation, aspiration pneumonia, ARDS, acute renal failure, chemical pneumonitis and shock.…”

“…7 Hematochezia and blood vomitus may be seen with 30 to 4 ml FA ingestion associa ted with acute abdomen and dark red urine. 7,8 Common complaints were oral cavity burns, metabolic acidosis, septicemia, dysphagia, esophageal stricture, gastrointestinal perforation, aspiration pneumonia, ARDS, acute renal failure, chemical pneumonitis and shock. 7,8 Skin contacts cause erythema, blisters and severe skin burns, while corneal injuries cause clouding and loss of vision.…”

“…7,8 Common complaints were oral cavity burns, metabolic acidosis, septicemia, dysphagia, esophageal stricture, gastrointestinal perforation, aspiration pneumonia, ARDS, acute renal failure, chemical pneumonitis and shock. 7,8 Skin contacts cause erythema, blisters and severe skin burns, while corneal injuries cause clouding and loss of vision. 710 Inhalation of the vapor can cause respiratory distress syndrome, aspiration pneumonitis and shock lung.…”

“…7,8 Its absorbed readily from the gut mucosa, but the coagulative necrosis may lead onto perforation. 7,8 Rare complications were tracheo eso phageal fistula and pneumomediastinum can occur.…”