Pulmonary fibrosis and pericarditis as a complication of chronic gasoline poisoning: A case report

Abstract

In this paper, the authors report a case of pulmonary fibrosis and pericarditis which they believe were caused by chronic gasoline poisoning. The patient, a 15 yr old Thai boy, worked at a gasoline station. While working at this place, he stole the gasoline from the motor cars in the parking lot, by putting a rubber tube into the tanks and sucking the gasoline out. In this process, he swallowed and aspirated gasoline into his stomach and lungs several times. The patient had symptoms for several mth before admission and had a history of repeated exposures, so it could be classified as chronic poisoning. Pulmonary fibrosis in this condition may be due to the result of healing of repeated necrotizing inflammations of the lung parenchyma. Pleural involvement was likely due to the direct extension of the inflammatory process. The patient had no typical history of bacterial pneumonitis, such as fever, shaking and a chilly sensation or productive coughs. Furthermore, sputum culture for bacteria grew only a few alpha streptococci which are normal bacterial flora in the mouth. Sputum smears also showed numerous polymorphonuclear cells without any organisms. From the history and sputum examinations, the authors feel that the process in the lung was unlikely to have been caused by infections but due rather to the result of chemical irritation. They believe that the superimposed bacterial infection of the lung may be present, but is likely to play only a minor role in pathologic changes. Pericarditis and pericardial fibrosis are also likely to have resulted from direct extension of the inflammatory process in the pleurae.