Case Study Of Kerosene

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Background: Kerosene is one of the most widely used sources of energy in developing countries. Modes of accidental exposure include inhalation, ingestion and through skin or eye contact. There have been few cases reported in literature where kerosene was injected intravenously and subcutaneously with differing outcomes ranging from mild irritation to serious necrotizing fasciitis. It remains challenging to predict the outcome of patients who inject kerosene via non-venous route as it is difficult to establish the accuracy of tissue layer affected by the injection
Objective: To establish methods of management available in the rare presentation of attempted suicide by self-injection of kerosene.
Design: An analysis of Case Studies
Setting: Training
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Most reported cases are in Arab countries (KSA, Jordan, Iraq) (15 cases) [2-6]. Iraq is the highest of Arab countries (11 cases) [4]. The difficulty arises in management as cases are unique to each exposure in terms of dose injected, site of intended versus actual injection and quantification of the exact dose of exposure. The lethal dose of kerosene for 70 kg adult is 100 ml [7]. Only 12.9% (4 cases) had reported the exact dose of kerosene that was used. Routes of kerosene exposure included: intradermal, subcutaneous and intravenous. Superficial skin contact with kerosene may cause dryness scaling and dermatitis [8]. Injection of kerosene presents with a more severe clinical presentation in the form of local unspecified inflammation, aggregation of neutrophils and soft tissue necrosis. This was demonstrated in two histopathology specimens of debrided necrotic tissue in two reported cases [2,3]. Intradermal injection has been reported in 32% of cases (10 cases) [4]. All treated medically as a case of panniculitis and skin ulceration. Patients recovered without complications except one who has developed injection site fibrosis and contracture in the wrist and
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